Provider Demographics
NPI:1407045834
Name:VASQUEZ CASTELLANOS, RAUL ALBERTO (MD)
Entity Type:Individual
Prefix:MR
First Name:RAUL
Middle Name:ALBERTO
Last Name:VASQUEZ CASTELLANOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8950 N KENDALL DR STE 407W
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2132
Mailing Address - Country:US
Mailing Address - Phone:305-271-6159
Mailing Address - Fax:786-533-9989
Practice Address - Street 1:8950 N KENDALL DR STE 407W
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2132
Practice Address - Country:US
Practice Address - Phone:305-271-6159
Practice Address - Fax:786-533-9989
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME139598207T00000X
FLME106464207T00000X
TNMD51771207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012055000Medicaid
FLHU710ZMedicare PIN