Castrillon, Tabitha

Castrillon, Tabitha is an individual health care provider with primary practice located at 1075 Mason Ave , Daytona Beach FL 32117-4611. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Castrillon, Tabitha can be contacted via phone (386) 255-4596.

Contact Information

Primary practice address
1075 Mason Ave Daytona Beach FL 32117-4611
Phone: (386) 255-4596
Fax: (386) 258-3561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9112512 Florida
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9112512
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9112512 Florida

Profile Details

NPI number 1770129413
LBN Legal business name Castrillon, Tabitha
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2019
Last updated May 22nd, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770129413 NPPES
Florida MEDICAID 104925100

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