Organization Active NPI

Guillermo Castellvi MD PA

  • Surgery Physician
  • Tampa, FL
National Provider Identifier
1427421106
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME44641 Issued in FL
Legal business name
GUILLERMO CASTELLVI MD PA
Practice address
11033 Countryway Blvd
Tampa, FL 33626-2628
Phone
(813) 196-9900
Fax
(813) 496-9920
NPI assigned
Nov 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Guillermo O. Castellvi, MDNPI 1750413514
Title
Owner
Phone
(813) 196-9900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X ME44641 FL Primary

Addresses

Primary practice location

11033 Countryway Blvd
Tampa, FL 33626-2628

Mailing address

PO Box 320502
Tampa, FL 33679-2502
Phone (813) 496-9900

Other identifiers 1

IdentifierTypeStateIssuer
259319000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160428000421 FL Part B Supplier - Clinic/Group Practice 8527367465 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

11033 Countryway Blvd
Ste A
Tampa, FL 33626
Phone (813) 496-9900

11033 Countryway Blvd
Tampa, FL 33626
Phone (813) 496-9900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1427421106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320502",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336792502",
            "telephone_number": "813-496-9900",
            "fax_number": "813-496-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11033 COUNTRYWAY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336262628",
            "telephone_number": "813-196-9900",
            "fax_number": "813-496-9920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUILLERMO CASTELLVI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "CASTELLVI",
        "authorized_official_first_name": "GUILLERMO",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-196-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME44641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259319000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.