Provider Demographics
NPI:1992301881
Name:CASTRO GUEVARA, JOSE E (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:E
Last Name:CASTRO GUEVARA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 NW 136TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-1900
Mailing Address - Country:US
Mailing Address - Phone:915-271-2695
Mailing Address - Fax:
Practice Address - Street 1:16340 NW 59TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-5601
Practice Address - Country:US
Practice Address - Phone:305-789-8889
Practice Address - Fax:305-370-7288
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22106208D00000X
FLACN1326208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice