Healthcare Provider Details
I. General information
NPI: 1205625878
Provider Name (Legal Business Name): B CASTILLO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1395 CALLE SAN RAFAEL
SAN JUAN PR
00909-2518
US
IV. Provider business mailing address
PO BOX 190053
SAN JUAN PR
00919-0053
US
V. Phone/Fax
- Phone: 787-598-1346
- Fax:
- Phone: 787-598-1346
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BERFA
CASTILLO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-598-1346