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General NPI Number Information
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NPI Number | 1578521340
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Entity Type | Individual
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Provider Name | DR. MARIA LOURDES CASTELLVI
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Gender | Female
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 04/11/2013
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Provider Practice Location Address
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Address Line | 775 CALLE CAOBA CENTRO COMERCIAL LOS CAOBOS STE. 25
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City | PONCE
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State | PR
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Zip | 00716-2610
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Country | US
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Telephone | 787-841-5111
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Fax | 787-841-5111
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Provider Business Mailing Address
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Address Line | PO BOX 7215
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City | PONCE
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State | PR
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Zip | 00732-7215
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Country | US
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Telephone | 787-841-5111
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Fax | 787-841-5111
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 1618
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License Number State | PR
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