Provider Demographics
NPI:1457333411
Name:CASTILLO, JUAN G (MD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:G
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4700 MILLENIA BLVD STE 650
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-6013
Mailing Address - Country:US
Mailing Address - Phone:407-533-6836
Mailing Address - Fax:407-232-9316
Practice Address - Street 1:3601 S BUSINESS HIGHWAY 281
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-0287
Practice Address - Country:US
Practice Address - Phone:956-271-0131
Practice Address - Fax:888-815-0809
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2023-10-05
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Provider Licenses
StateLicense IDTaxonomies
TXM1042207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190222101Medicaid
TX8BU383OtherBCBS TX
TX8L9406Medicare PIN
TX8BU383OtherBCBS TX