DR. JOSE E. CASTELLON MIRANDA - NPI NUMBER 1194848309

Summary

Provider Name: DR. JOSE E. CASTELLON MIRANDA

NPI Number: 1194848309

Clasification: General Practice (208D00000X)

Address:
61 CALLE COMERCIO
YAUCO, PR
ZIP 00698

Phone Number: (787) 856-0844



Detailed Information

DR. Jose E. Castellon Miranda is a general practitioner in Yauco, PR. The assigned NPI number for this provider is 1194848309 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

61 CALLE COMERCIO
YAUCO, PR
ZIP 00698-541
Phone: (787) 856-0844
Fax: (787) 267-5554

The enumeration date for this NPI number is 4/10/2007 and was last updated on 4/20/2011.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 208D00000X General Practice 12428 PR Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 89014 MEDICARE ID-TYPE UNSPECIFIED PR

NPI Record

No. Field Name Field Value
1 NPI 1194848309
2 Entity Type Code 1
3 Provider Last Name Legal Name CASTELLON MIRANDA
4 Provider First Name JOSE
5 Provider Middle Name E.
6 Provider Name Prefix Text DR.
7 Provider First Line Business Practice Location Address 61 CALLE COMERCIO
8 Provider Business Practice Location Address City Name YAUCO
9 Provider Business Practice Location Address State Name PR
10 Provider Business Practice Location Address Postal Code 006983541
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 7878560844
13 Provider Business Practice Location Address Fax Number 7872675554
14 Provider Enumeration Date 4/10/2007
15 Last Update Date 4/20/2011
16 Provider Gender Code M
17 Healthcare Provider Taxonomy Code 1 208D00000X
18 Provider License Number 1 12428
19 Provider License Number State Code 1 PR
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Other Provider Identifier 1 89014
22 Other Provider Identifier Type Code 1 04
23 Other Provider Identifier State 1 PR
24 Is Sole Proprietor Y

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This page was last updated on: 8/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.