Provider Demographics
NPI:1326811696
Name:BORIA CASTRO, JEMILANY
Entity Type:Individual
Prefix:
First Name:JEMILANY
Middle Name:
Last Name:BORIA CASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE AMARILIS A3-2, URBANIZACION LOS CAOBOS
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968
Mailing Address - Country:US
Mailing Address - Phone:787-508-6627
Mailing Address - Fax:
Practice Address - Street 1:CALLE AMARILIS A3-2, URBANIZACION LOS CAOBOS
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-0096
Practice Address - Country:US
Practice Address - Phone:787-508-6627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26570104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker