MEDICARE: DR. JOSE JULIAN CASTRO DIAZ

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	174400000X	Specialist	7067	PR
2	208800000X	Urology Physician	7067	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	601254	OTHER	PR	MEDICARE Y MUCHO MAS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2-8451CA	OTHER	PR	SSS
2	M00324	OTHER	PR	PLAN DE SALUD MENONITA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609875335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE JULIAN CASTRO DIAZ

Provider Business Mailing Address
First Line	:	PO BOX 2056
Second Line	:
City	:	AIBONITO
State	:	PR
Zip	:	00705-2056
Country	:	US
Telephone Number	:	787-735-7500
Fax Number	:	787-735-7500

Provider Business Practice Location Address
First Line	:	EDIFICION PROFESSIONAL, 301 HOSPITAL MEMOMITA
Second Line	:	CALLE JOSE SABASTIAN
City	:	AIBONITO
State	:	PR
Zip	:	00705-2056
Country	:	US
Telephone Number	:	787-735-7500
Fax Number	:	787-735-7500

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	12/01/2008

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Directions to “ DR. JOSE JULIAN CASTRO DIAZ ” Practice Location

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