MEDICARE: CHRISTIAN CASTILLO LATORRE 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	390200000X	Student in an Organized Health Care Education/Training Program	33574	PR
2	390200000X	Student in an Organized Health Care Education/Training Program	33196	PR
3	207R00000X	Internal Medicine Physician	32437	PR

General Provider Information

NPI Number	:	1235686601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN CASTILLO LATORRE M.D

Provider Business Mailing Address
First Line	:	HOSPITAL MUNICIPAL SAN JUAN
Second Line	:	CENTRO MEDICO DE PURTO RICO
City	:	SAN JUAN
State	:	PR
Zip	:	00936
Country	:	US
Telephone Number	:	787-617-7363
Fax Number	:

Provider Business Practice Location Address
First Line	:	CENTRO MEDICO DE PUERTO RICO
Second Line	:	BO. MONACILLOS
City	:	SAN JUAN
State	:	PR
Zip	:	00917
Country	:	US
Telephone Number	:	787-617-7363
Fax Number	:

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

Provider Enumeration Date	:	09/02/2016
Last Update Date	:	10/04/2018

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