Provider Demographics
NPI:1528411774
Name:CASADO CASTILLO, FERNANDO ERNESTO (MD)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:ERNESTO
Last Name:CASADO CASTILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 HOLIDAY RD APT E5
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2786
Mailing Address - Country:US
Mailing Address - Phone:914-309-4810
Mailing Address - Fax:
Practice Address - Street 1:4033 TALBOT RD S STE 570
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5700
Practice Address - Country:US
Practice Address - Phone:425-690-3487
Practice Address - Fax:425-690-9087
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61417522207R00000X, 207RI0200X
IAMD-45957207RI0200X
WI74676207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine