Provider Demographics
NPI:1790901502
Name:CASTRO, JONATHAN TROADIO AZARCON (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN TROADIO
Middle Name:AZARCON
Last Name:CASTRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:520 SOUTH MAIN ST
Mailing Address - Street 2:SUITE 2446A
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311
Mailing Address - Country:US
Mailing Address - Phone:330-253-7415
Mailing Address - Fax:330-253-5260
Practice Address - Street 1:224 W. EXCHANGE ST
Practice Address - Street 2:SUITE 380
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302
Practice Address - Country:US
Practice Address - Phone:330-344-6676
Practice Address - Fax:330-434-3611
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2013-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.088317207RP1001X, 207RC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2754603Medicaid
OH2754603Medicaid