Provider Demographics
NPI:1477976736
Name:MEDTRACK, INC
Entity Type:Organization
Organization Name:MEDTRACK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:407-616-8602
Mailing Address - Street 1:PO BOX 1991
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32790-1991
Mailing Address - Country:US
Mailing Address - Phone:407-616-8602
Mailing Address - Fax:407-872-0286
Practice Address - Street 1:861 W. MORSE BLVD
Practice Address - Street 2:SUITE 225
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789
Practice Address - Country:US
Practice Address - Phone:407-616-8602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-22
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management