MEDICARE: YAMIL E. CASTILLO BEAUCHAMP MD

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	208600000X	Surgery Physician	18258	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	18258	OTHER	PR	MEDICAL LICENSE

General Provider Information

NPI Number	:	1528264702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAMIL E. CASTILLO BEAUCHAMP MD

Provider Business Mailing Address
First Line	:	425 CARR 693
Second Line	:	PMB 384
City	:	DORADO
State	:	PR
Zip	:	00646-0000
Country	:	US
Telephone Number	:	787-621-4816
Fax Number	:

Provider Business Practice Location Address
First Line	:	MANATI MEDICAL CENTER PROFESSIONAL PLAZA SUITE 504
Second Line	:	CALLE HERNANDEZ CARRION
City	:	DORADO
State	:	PR
Zip	:	00646-0000
Country	:	US
Telephone Number	:	787-621-4816
Fax Number	:

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	07/21/2022

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