MEDICARE: SAMUEL SOSTRE CASTILLO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	20700000X	PR

General Provider Information

NPI Number	:	1184652869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL SOSTRE CASTILLO M.D.

Provider Business Mailing Address
First Line	:	325 CALLE SORBONA
Second Line	:	UNIVERSITY GARDENS
City	:	SAN JUAN
State	:	PR
Zip	:	00927-4012
Country	:	US
Telephone Number	:	787-781-1477
Fax Number	:	787-793-2881

Provider Business Practice Location Address
First Line	:	T-31 CARR 21
Second Line	:	LAS LOMAS
City	:	SAN JUAN
State	:	PR
Zip	:	00921-3312
Country	:	US
Telephone Number	:	787-781-1477
Fax Number	:	787-793-2881

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	07/08/2007

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