Provider Demographics
NPI:1083147433
Name:CASTILLO, AMAURY (ARNP)
Entity Type:Individual
Prefix:MR
First Name:AMAURY
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12054 SW 116TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5104
Mailing Address - Country:US
Mailing Address - Phone:305-505-3365
Mailing Address - Fax:
Practice Address - Street 1:7867 N KENDALL DR STE 130&135
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7742
Practice Address - Country:US
Practice Address - Phone:305-598-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3254842363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily