Provider Demographics
NPI:1164699583
Name:CASTRO, ISABEL CRISTINA (DO)
Entity Type:Individual
Prefix:DR
First Name:ISABEL
Middle Name:CRISTINA
Last Name:CASTRO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ISABEL
Other - Middle Name:CRISTINA
Other - Last Name:CASTRO MUNOZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:55 LAKE AVE N
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655
Practice Address - Country:US
Practice Address - Phone:508-334-8630
Practice Address - Fax:774-441-6710
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN52427207R00000X
MA270042207R00000X, 207RH0002X
OR168039207RH0002X
IA04128207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN110013295Medicare PIN