Healthcare Provider Details

I. General information

NPI: 1205028420
Provider Name (Legal Business Name): WANDA I CASTRO-BORRERO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2007
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 660
CAMUY PR
00627-0660
US

IV. Provider business mailing address

PO BOX 141914
ARECIBO PR
00614-1914
US

V. Phone/Fax

Practice location:
  • Phone: 787-880-2701
  • Fax:
Mailing address:
  • Phone: 860-301-3464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number050068
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number24585
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: