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General NPI Number Information
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NPI Number | 1194848309
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Entity Type | Individual
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Provider Name | DR. JOSE E. CASTELLON MIRANDA
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 09/05/2018
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Provider Practice Location Address
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Address Line | 71 CALLE COMERCIO
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City | YAUCO
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State | PR
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Zip | 00698
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Country | US
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Telephone | 787-856-0844
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Fax | 787-267-5554
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Provider Business Mailing Address
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Address Line | PO BOX 5004 PMB 301
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City | YAUCO
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State | PR
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Zip | 00698-0069
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Country | US
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Telephone | 939-928-9002
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Fax | 939-928-9003
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 12428
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License Number State | PR
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