Provider Demographics
NPI:1295060697
Name:CASTILLO MUNIZ EYE ASSOCIATES INC
Entity type:Organization
Organization Name:CASTILLO MUNIZ EYE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-205-5955
Mailing Address - Street 1:12163 GRAND PINE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-4435
Mailing Address - Country:US
Mailing Address - Phone:305-205-5955
Mailing Address - Fax:
Practice Address - Street 1:4250 PHILIPS HWY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-6730
Practice Address - Country:US
Practice Address - Phone:904-737-7377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-02
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC002849152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620096600Medicaid
FL620096600Medicaid
FLU5764Medicare UPIN