Individual
DR. CARLOS H CASTELLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
152 NW OTTER CT, LAKE CITY, FL 32055-7252
(386) 752-4199
Mailing address
152 NW OTTER CT, LAKE CITY, FL 32055-7252
(386) 752-4199
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME46096
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0430749-00
—
FL
01
—
12072N
MEDICARE
FL
05
—
43074900
—
FL
Enumeration date
07/19/2006
Last updated
05/14/2008
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