1427052901 NPI number — ARTURO RAFAEL CASTRO MD

Table of content: ARTURO RAFAEL CASTRO MD (NPI 1427052901)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427052901 NPI number — ARTURO RAFAEL CASTRO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASTRO
Provider First Name:
ARTURO
Provider Middle Name:
RAFAEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427052901
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2046 TREASURE COAST PLAZA, SUITE A #356
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VERO BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32960
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-301-1692
Provider Business Mailing Address Fax Number:
321-301-1691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1019 HARVIN WAY STE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCKLEDGE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32955-3286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-301-1692
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X , with the licence number:  ME90073 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 43242 . This is a "FLORIDA BLUE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 269654100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 43242 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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