Provider Demographics
NPI:1629246343
Name:ALBERT CASTELLON, M.D., P.A.
Entity Type:Organization
Organization Name:ALBERT CASTELLON, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:CASTELLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-491-9801
Mailing Address - Street 1:4613 N UNIVERSITY DR
Mailing Address - Street 2:419
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4602
Mailing Address - Country:US
Mailing Address - Phone:954-491-9801
Mailing Address - Fax:954-491-9808
Practice Address - Street 1:4613 N UNIVERSITY DR
Practice Address - Street 2:419
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4602
Practice Address - Country:US
Practice Address - Phone:305-970-3193
Practice Address - Fax:954-827-0213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME883952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7054Medicare PIN