Individual provider Active NPI

Antonio Castillo, M.D.

  • General Practice Physician
  • Davenport, FL
National Provider Identifier
1639388481
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ACN1074 Issued in FL
Practice address
216 Boxwood Dr
Davenport, FL 33837-5548
Phone
(787) 212-9163
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 12630 PR
General Practice Physician 208D00000X ACN1074 FL Primary

Addresses

Primary practice location

216 Boxwood Dr
Davenport, FL 33837-5548

Mailing address

216 Boxwood Dr
Davenport, FL 33837-5548
Phone (863) 978-8723

Other practice location 1

Urb. Interamericana
AE-20 Calle 31
Trujillo Alto, PR 00976-3410
Phone (787) 466-2428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050304000171 PR Practitioner - General Practice 4284688003 Practice locations: Trujillo Alto, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: antonio.castillo@4342.securemail.prognocis.com

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1639388481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 BOXWOOD DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375548",
            "telephone_number": "863-978-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 BOXWOOD DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375548",
            "telephone_number": "787-212-9163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Urb. Interamericana",
            "address_2": "AE-20 Calle 31",
            "address_purpose": "LOCATION",
            "city": "Trujillo Alto",
            "state": "PR",
            "postal_code": "009763410",
            "country_code": "US",
            "telephone_number": "787-466-2428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "12630",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN1074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.