Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 9785 | PR |
NPI | 1013945286 |
---|---|
Provider Name | Dr. Oreste Castellanos |
First Address | Mayaguez, PR 00681-8043 |
Second Address | Mayaguez, PR 00682-6353 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
82156 | (02) | PR |