Provider Demographics
NPI:1386653954
Name:CASTRO, RAYMOND J (BC, LDO)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:J
Last Name:CASTRO
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Gender:M
Credentials:BC, LDO
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Mailing Address - Street 1:11200 SW 8TH ST STE 160
Mailing Address - Street 2:FLORIDA INTERNATIONAL UNIVERSITY MMC
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33199-2516
Mailing Address - Country:US
Mailing Address - Phone:305-348-8439
Mailing Address - Fax:305-348-8330
Practice Address - Street 1:11200 SW 8TH ST
Practice Address - Street 2:COLLEGE OPTICAL EXPRESS @ FIU, PG-6, SUITE 160
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199-2156
Practice Address - Country:US
Practice Address - Phone:305-348-8439
Practice Address - Fax:305-348-8330
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2016-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLDO4855156FC0801X, 156FX1800X, 1744R1103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter
No1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/Coder
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDO4855OtherLICENSE NUMBER