Healthcare Provider Details

I. General information

NPI: 1295108785
Provider Name (Legal Business Name): XIOMARA CASILLAS 18055 RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2015
Last Update Date: 11/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 1 BOX 4593
NAGUABO PR
00718-9722
US

IV. Provider business mailing address

HC-1 BOX 4593
NAGUABO PUERTO RICO
00718
UM

V. Phone/Fax

Practice location:
  • Phone: 787-861-7777
  • Fax: 787-266-7318
Mailing address:
  • Phone: 787-861-7777
  • Fax: 787-266-7318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number18055
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: