Organization
JACASTILLANO PLLC
Active
Other names
JACASTILLANO PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE A CASTILLANO MD (CEO)
(904) 252-3930
Entity
Organization
Contact information
Practice address
5310 BREEZE HILL PL, TROY, MI 48098-2725
(904) 252-3930
Mailing address
54626 MORNINGSIDE DR, SHELBY TOWNSHIP, MI 48316-6001
(904) 252-3930
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
4301100455
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301100455
MI LIC#
MI
Enumeration date
11/14/2017
Last updated
02/02/2025
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