Provider Demographics
NPI:1457465692
Name:CASTILLO, ANA MARIA (RPH CPH)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:RPH CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 SE 47TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-9674
Mailing Address - Country:US
Mailing Address - Phone:239-233-5572
Mailing Address - Fax:
Practice Address - Street 1:1303 SE 47TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9674
Practice Address - Country:US
Practice Address - Phone:239-542-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 33162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist