Organization
ORLANDO J. CASTILLO M.D., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENKATA REDDIVARI M.D (PHYSICIAN)
(813) 873-7479
Entity
Organization
Contact information
Practice address
2810 W SAINT ISABEL ST, SUITE 101, TAMPA, FL 33607-6375
(813) 873-7479
Mailing address
2810 W SAINT ISABEL ST, SUITE 101, TAMPA, FL 33607-6375
(813) 873-7479
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME116695
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME116695
FLORIDA STATE LISENCE
FL
Enumeration date
10/18/2016
Last updated
10/18/2016
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