Healthcare Provider Details

I. General information

NPI: 1083610042
Provider Name (Legal Business Name): WILLIAM HENRY CASTRO M.D., F.A.C.O.G.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date: 03/16/2006
Reactivation Date: 03/24/2006

III. Provider practice location address

500 AVE DEGETAU HIMA PLAZA 1, SUITE 301
CAGUAS PR
00725-7301
US

IV. Provider business mailing address

PO BOX 697
CAGUAS PR
00726-0697
US

V. Phone/Fax

Practice location:
  • Phone: 787-653-3126
  • Fax:
Mailing address:
  • Phone: 623-363-0721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number18402
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number17160
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: