Healthcare Provider Details
I. General information
NPI: 1275366387
Provider Name (Legal Business Name): CASTLING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/23/2024
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1429 AVE FERNANDEZ JUNCOS STE 3
SAN JUAN PR
00909-2658
US
IV. Provider business mailing address
1304 CALLE WILSON APT 8S
SAN JUAN PR
00907-2243
US
V. Phone/Fax
- Phone: 787-722-2371
- Fax: 787-722-2374
- Phone: 787-536-2033
- Fax: 787-722-2374
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
UBALDO
G
SANTIAGO
Title or Position: PRESIDENT, SECRETARY, TREASURER
Credential: MD
Phone: 787-536-2033