Provider Demographics
NPI:1407920580
Name:CASTRO-DIAZ, ESTEBAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ESTEBAN
Middle Name:
Last Name:CASTRO-DIAZ
Suffix:
Gender:M
Credentials:MD
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 8820
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988-8820
Mailing Address - Country:US
Mailing Address - Phone:787-860-6300
Mailing Address - Fax:787-860-0036
Practice Address - Street 1:DL13 VIA EMILIA
Practice Address - Street 2:URB. VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-3907
Practice Address - Country:US
Practice Address - Phone:787-768-1355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8507207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR080204OtherSSS
PR214022OtherPREFERRED
PR069910OtherCRUZ AZUL OF PUERTO RICO
PR8000408OtherHUMANA
PR03365OtherAMERICAN HEALTH
PR601192OtherMMM
PR36825OtherASOCIACION DE MAESTROS
PR36825OtherASOCIACION DE MAESTROS
PR0080204Medicare ID - Type Unspecified