Organization
ALLEN R CASTELLO MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY B KIAH PECK (BILLING MANAGER)
(407) 877-4458
Entity
Organization
Contact information
Practice address
1173 BLACKWOOD AVE, OCOEE, FL 34761-4518
(407) 877-4458
(407) 877-4494
Mailing address
1173 BLACKWOOD AVE, OCOEE, FL 34761-4518
(407) 877-4458
(407) 877-4494
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME56679
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10227
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/29/2009
Last updated
01/29/2009
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