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NPI Code Detail

MEDICARE: MAHRY TORRES-CASTILLO

MEDICARE: MAHRY TORRES-CASTILLO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health WorkerMN

General Provider Information

NPI Number : 1366974594
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAHRY TORRES-CASTILLO
Provider Business Mailing Address
First Line : 4615 PENKWE WAY
Second Line :
City : EAGAN
State : MN
Zip : 55122-3719
Country : US
Telephone Number : 651-410-7098
Fax Number :
Provider Business Practice Location Address
First Line : 14955 GALAXIE AVE
Second Line :
City : APPLE VALLEY
State : MN
Zip : 55124-4519
Country : US
Telephone Number : 952-891-7517
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2017
Last Update Date : 03/05/2020

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Directions to “ MAHRY TORRES-CASTILLO ” Practice Location

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