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General NPI Number Information
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NPI Number | 1720057151
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Entity Type | Individual
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Provider Name | ERICK CASTILLO-BACA MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 9600 SW 8TH ST STE 18
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City | MIAMI
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State | FL
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Zip | 33174-2947
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Country | US
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Telephone | 305-266-0600
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Fax | 305-266-2040
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Provider Business Mailing Address
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Address Line | D31 CALLE TREVI
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City | SAN JUAN
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State | PR
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Zip | 00924-5021
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Country | US
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Telephone | 788-308-3388
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Fax |
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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 | 15247
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License Number State | PR
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