Provider Demographics
NPI:1427199652
Name:RENES CASTOR MD PA
Entity Type:Organization
Organization Name:RENES CASTOR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RENES
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-478-7659
Mailing Address - Street 1:1525 STONEHAVEN ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-6621
Mailing Address - Country:US
Mailing Address - Phone:561-478-7659
Mailing Address - Fax:877-317-6158
Practice Address - Street 1:3933 HAVERHILL RD N STE 115
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-7424
Practice Address - Country:US
Practice Address - Phone:561-478-7659
Practice Address - Fax:877-317-6158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43329207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty