Healthcare Provider Details

I. General information

NPI: 1477498442
Provider Name (Legal Business Name): GISELLE CASTRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE JUAN SAN ANTONIO EDIF 207
MOCA PR
00676
US

IV. Provider business mailing address

CALLE 31 GG 13 EXT VILLA RITA
SAN SEBASTIAN PR
00685
US

V. Phone/Fax

Practice location:
  • Phone: 787-818-0100
  • Fax:
Mailing address:
  • Phone: 787-818-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8667
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: