Provider Demographics
NPI:1003867698
Name:MOTA-CASTILLO, MANUEL RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:RAMON
Last Name:MOTA-CASTILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MANUEL
Other - Middle Name:R
Other - Last Name:MOTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5979 VINELAND RD STE 109
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7857
Mailing Address - Country:US
Mailing Address - Phone:407-270-7702
Mailing Address - Fax:407-270-7705
Practice Address - Street 1:5979 VINELAND RD STE 109
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7857
Practice Address - Country:US
Practice Address - Phone:407-270-7702
Practice Address - Fax:407-270-7705
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME827472084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262732900Medicaid
NMC77777Medicare UPIN
FLE6252TMedicare PIN
FL262732900Medicaid
FLE6252XMedicare PIN