MEDICARE: CASTILLO Y ASOCIADOS LLC

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1386210433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASTILLO Y ASOCIADOS LLC

Provider Business Mailing Address
First Line	:	1007 AVE MUNOZ RIVERA APT 1001
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00925-2724
Country	:	US
Telephone Number	:	787-957-5788
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007 AVE MUNOZ RIVERA APT 1001
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00925-2724
Country	:	US
Telephone Number	:	787-957-5788
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JUANA P CASTILLO MUNOZ
Credential	:	PHD
Telephone Number	:	787-957-5788

Provider Enumeration Date	:	05/31/2021
Last Update Date	:	05/31/2021

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