MEDICARE: KATHERINE PENA CASTILLO PA

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	363AM0700X	Medical Physician Assistant	2495	PR

General Provider Information

NPI Number	:	1619821345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE PENA CASTILLO PA

Provider Business Mailing Address
First Line	:	URB. SAN AGUSTIN 455 CALLE 6
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-1922
Country	:	US
Telephone Number	:	787-460-2051
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB. SAN AGUSTIN 455 CALLE 6
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-1922
Country	:	US
Telephone Number	:	787-460-2051
Fax Number	:

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

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/20/2026

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Directions to “ KATHERINE PENA CASTILLO PA” Practice Location

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