Provider Demographics
NPI:1215598644
Name:CASTRO NUNEZ, JAIME ALBERTO (DMD)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:ALBERTO
Last Name:CASTRO NUNEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5M5 CALLE PARQUE DEL CONDADO
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-3723
Mailing Address - Country:US
Mailing Address - Phone:859-433-6625
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSIDAD DE PUERTO RICO RECINTO DE CIENCIAS MEDICAS
Practice Address - Street 2:PASEO DR JOSE CELSO BARBOSA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-0092
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR029-R1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery