MEDICARE: MR. JOEL CASTILLO 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	208D00000X	General Practice Physician	16606	PR

General Provider Information

NPI Number	:	1952419467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOEL CASTILLO MD

Provider Business Mailing Address
First Line	:	CALLE 1 BLOQUE 1 #13
Second Line	:	URB. SIERRA BAYAMON,
City	:	BAYAMON
State	:	PR
Zip	:	00961
Country	:	US
Telephone Number	:	786-382-1688
Fax Number	:

Provider Business Practice Location Address
First Line	:	2004 AVE BORINQUEN
Second Line	:	BO OBRERO
City	:	SANTURCE
State	:	PR
Zip	:	00915-3824
Country	:	US
Telephone Number	:	787-268-0225
Fax Number	:

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	07/08/2007

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