Individual
MIGUEL S CASTILLO DE FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1121 PARK LN, HAVERHILL, FL 33417-5956
(305) 389-5375
Mailing address
1121 PARK LN, HAVERHILL, FL 33417-5956
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/04/2017
Last updated
03/04/2017
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