Provider Demographics
NPI:1548043094
Name:CASTILLO, ROBERTO (PT)
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2-2514 KAUMUALII HWY STE 211
Mailing Address - Street 2:
Mailing Address - City:KALAHEO
Mailing Address - State:HI
Mailing Address - Zip Code:96741-8304
Mailing Address - Country:US
Mailing Address - Phone:808-808-4958
Mailing Address - Fax:808-495-8669
Practice Address - Street 1:2-2514 KAUMUALII HWY STE 211
Practice Address - Street 2:
Practice Address - City:KALAHEO
Practice Address - State:HI
Practice Address - Zip Code:96741-8304
Practice Address - Country:US
Practice Address - Phone:808-808-4958
Practice Address - Fax:808-495-8669
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist