Provider Demographics
NPI:1447250162
Name:CASTILLO, ORLANDO ALFONSO (MD)
Entity type:Individual
Prefix:
First Name:ORLANDO
Middle Name:ALFONSO
Last Name:CASTILLO
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 1:42 STRICKLAND WAY
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1667
Mailing Address - Country:US
Mailing Address - Phone:610-532-1300
Mailing Address - Fax:619-399-4675
Practice Address - Street 1:1098 W BALTIMORE PIKE
Practice Address - Street 2:SUITE 3303 RMH OP PAVILION
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5139
Practice Address - Country:US
Practice Address - Phone:610-532-1300
Practice Address - Fax:610-399-4675
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 051044 L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG03584Medicare UPIN
PACA688150Medicare ID - Type Unspecified