1184761900 NPI number — VICTOR M CASTILLO TORRES

Table of content: (NPI 1184761900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184761900 NPI number — VICTOR M CASTILLO TORRES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VICTOR M CASTILLO TORRES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184761900
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1163
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANASCO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00610-1163
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-826-2275
Provider Business Mailing Address Fax Number:
787-826-5211

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
42 CALLE 65 INFANTERIA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANASCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00610-2902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-826-2275
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CASTILLO
Authorized Official First Name:
VICTOR
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
17878262275

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  359 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 40D0675943 . This is a "CLIA" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com