Provider Demographics
NPI:1962066951
Name:CTMD MEDICAL CENTER PA
Entity type:Organization
Organization Name:CTMD MEDICAL CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-324-7224
Mailing Address - Street 1:2328 S CONGRESS AVE # UNITE1-H
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7618
Mailing Address - Country:US
Mailing Address - Phone:561-324-7224
Mailing Address - Fax:561-225-1780
Practice Address - Street 1:2328 S CONGRESS AVE # UNITE1-H
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33406-7618
Practice Address - Country:US
Practice Address - Phone:561-324-7224
Practice Address - Fax:561-225-1780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty