Provider Demographics
NPI:1902275183
Name:CASTELLON, BRISMAY (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:BRISMAY
Middle Name:
Last Name:CASTELLON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8821 NW 179TH LN
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6509
Mailing Address - Country:US
Mailing Address - Phone:305-342-0651
Mailing Address - Fax:
Practice Address - Street 1:14645 NW 77TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2569
Practice Address - Country:US
Practice Address - Phone:786-656-0428
Practice Address - Fax:786-656-0437
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9261083363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily