Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 1705 | PR |
Y | 213EG0000X | General Practice | 1705 | PR |
NPI | 1003812603 |
---|---|
Provider Name | Dr. Eric G Castrodad Ortiz |
First Address | Cidra, PR 00739 |
Second Address | Cidra, PR 00739 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 01/03/2017 |