Individual provider · NPI-1

Luis N Castillo Jr.

Technician/Technologist, Optician · Lakeland, FL

NPI number1922798792
StatusActive
Last updated in NPPESMay 15, 2023

Details

NPI
1922798792
Entity type
Individual (NPI-1)
Name
Luis N Castillo Jr.
Sex
Male
Sole proprietor
Yes
Enumeration date
May 15, 2023
Certification date
May 13, 2023
Last updated
May 15, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, OpticianDO7287FLYes

Practice location

3501 S Florida Ave
Lakeland, FL 33803-4860

Phone 863-644-9461 · Fax 863-644-0336

Mailing address

3501 S Florida Ave
Lakeland, FL 33803-4860

Phone 863-644-9461 · Fax 863-644-0336

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