Provider Demographics
NPI:1205258928
Name:CASTELL, TIMOTHY JR
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:CASTELL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 HARTLEY PLACE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805
Mailing Address - Country:US
Mailing Address - Phone:407-616-8602
Mailing Address - Fax:
Practice Address - Street 1:558 HARTLEY PLACE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805
Practice Address - Country:US
Practice Address - Phone:407-616-8602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator