Provider Demographics
NPI:1326259953
Name:CASTRO, ARISTIDES (LICENCIADO OPTICO)
Entity Type:Individual
Prefix:MR
First Name:ARISTIDES
Middle Name:
Last Name:CASTRO
Suffix:
Gender:M
Credentials:LICENCIADO OPTICO
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 319
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659
Mailing Address - Country:US
Mailing Address - Phone:787-262-1368
Mailing Address - Fax:787-262-1368
Practice Address - Street 1:CALLE PH HERNANDEZ #63
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-262-1368
Practice Address - Fax:787-262-1368
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR437156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101139OtherIVISION