Individual
IRELIS RODRIGUEZ CASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
110 POND CT, STE 301 AND 302, DEBARY, FL 32713-3234
(000) 000-0000
(818) 337-1454
Mailing address
110 POND CT, STE 301 AND 302, DEBARY, FL 32713-3234
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
19228
PR
208D00000X
General Practice Physician
Primary
ACN881
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ACN881
MEDICAL LICENSE
FL
Enumeration date
11/09/2015
Last updated
10/10/2023
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