Individual provider Active NPI

Luis Castellon

  • Physical Therapy Assistant
  • Orange City, FL
National Provider Identifier
1609768951
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA34192 Issued in FL
Practice address
2864 Wellness Ave Ste 100
Orange City, FL 32763-8335
Phone
(386) 575-4027
NPI assigned
Jul 18, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA34192 FL Primary

Addresses

Primary practice location

2864 Wellness Ave Ste 100
Orange City, FL 32763-8335

Mailing address

10649 Regent Square Dr
Orlando, FL 32825-4533
Phone (786) 704-5648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA34192FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1609768951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10649 REGENT SQUARE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254533",
            "telephone_number": "786-704-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2864 WELLNESS AVE STE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638335",
            "telephone_number": "386-575-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLON",
        "first_name": "LUIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-18",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA34192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.