Provider Demographics
NPI:1659868917
Name:CASTILLO GALVAN, RICARDO (MD MPH)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:
Last Name:CASTILLO GALVAN
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:RICARDO
Other - Middle Name:
Other - Last Name:CASTILLO-GALVAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD MPH
Mailing Address - Street 1:501 N ORANGE AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1350
Mailing Address - Country:US
Mailing Address - Phone:321-947-5206
Mailing Address - Fax:
Practice Address - Street 1:2200 FOWLER GROVE BLVD STE 220
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5597
Practice Address - Country:US
Practice Address - Phone:407-303-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-21
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program