Healthcare Provider Details

I. General information

NPI: 1316962921
Provider Name (Legal Business Name): EUGENIO GONZALEZ CASTILLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LAFAYETTE HOSPITAL MORSE STREET
ARROYO PR
00714
US

IV. Provider business mailing address

URB VALLE REAL INFANTA 1805
PONCE PR
00716
US

V. Phone/Fax

Practice location:
  • Phone: 787-839-3232
  • Fax:
Mailing address:
  • Phone: 787-813-8908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number10063
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: