Provider Demographics
NPI:1790007607
Name:GONZALEZ CASTELLON, MARCO AURELIO (MD)
Entity Type:Individual
Prefix:
First Name:MARCO
Middle Name:AURELIO
Last Name:GONZALEZ CASTELLON
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 1:988440 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8440
Mailing Address - Country:US
Mailing Address - Phone:402-559-4086
Mailing Address - Fax:
Practice Address - Street 1:4242 FARNAM ST STE 650
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-8480
Practice Address - Country:US
Practice Address - Phone:402-559-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE280762084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology