Provider Demographics
NPI:1700683331
Name:CASTILLO, PEDRO LOYNAZ (SA-C)
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:LOYNAZ
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10515 BASTILLE LN APT 207
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-4606
Mailing Address - Country:US
Mailing Address - Phone:407-627-7171
Mailing Address - Fax:
Practice Address - Street 1:10515 BASTILLE LN APT 207
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-4606
Practice Address - Country:US
Practice Address - Phone:407-627-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-171246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant