Provider Demographics
NPI:1982867420
Name:CASTILLANO, JESSE ALMONTE (MD)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:ALMONTE
Last Name:CASTILLANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54626 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-6001
Mailing Address - Country:US
Mailing Address - Phone:904-252-3930
Mailing Address - Fax:
Practice Address - Street 1:54626 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-6001
Practice Address - Country:US
Practice Address - Phone:904-252-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-04
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1691722085N0700X
TXBP100348162085N0700X
GA0029282085R0204X
MI43011004552085R0204X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology