Healthcare Provider Details

I. General information

NPI: 1932898228
Provider Name (Legal Business Name): REINALDO LUIS CASTRO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2153
UTUADO PR
00641-2153
US

IV. Provider business mailing address

PO BOX 276
ANGELES PR
00611-0276
US

V. Phone/Fax

Practice location:
  • Phone: 787-233-4581
  • Fax:
Mailing address:
  • Phone: 787-233-4581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number26205
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: