Provider Demographics
NPI:1154078012
Name:CASTILLO, OSVALDO NELSON (DPT)
Entity Type:Individual
Prefix:
First Name:OSVALDO
Middle Name:NELSON
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21000 NE 28TH AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1421
Mailing Address - Country:US
Mailing Address - Phone:305-935-9599
Mailing Address - Fax:
Practice Address - Street 1:21000 NE 28TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1421
Practice Address - Country:US
Practice Address - Phone:305-935-9599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-09
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist