Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 0116030235 | VA |
Y | 2086S0102X | Surgical Critical Care | OS019386 | PA |
N | 2086S0127X | Trauma Surgeon | OS019386 | PA |
NPI | 1144584731 |
---|---|
Provider Name | Dr. Roberto Carlos Castillo |
First Address | Fountain Hill, PA 18015-1152 |
Second Address | Fountain Hill, PA 18015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2012 |
Last Update Date | 09/08/2018 |