Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 15221 | PR |
NPI | 1033213483 |
---|---|
Provider Name | Ms. Sonya Castellanos |
First Address | San Sebastian, PR 00685-5346 |
Second Address | San Sebastian, PR 00685 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 08/07/2007 |