Provider Demographics
NPI:1548367782
Name:CASTILLO, RUBEN I JR (MD)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:I
Last Name:CASTILLO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1539
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1539
Mailing Address - Country:US
Mailing Address - Phone:787-831-7319
Mailing Address - Fax:787-868-2175
Practice Address - Street 1:ROAD 115 KM 245
Practice Address - Street 2:AGUADA COMPLEX BUILDING SUITE G
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-9730
Practice Address - Country:US
Practice Address - Phone:787-868-2040
Practice Address - Fax:787-868-2175
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7510207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E08540Medicare UPIN
0028132Medicare ID - Type Unspecified