Provider Demographics
NPI:1417357138
Name:CASUL, ANGEL L (MSPT)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:L
Last Name:CASUL
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND POLARIS
Mailing Address - Street 2:2000 CARR 857 APT 208
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-8826
Mailing Address - Country:US
Mailing Address - Phone:787-405-1152
Mailing Address - Fax:
Practice Address - Street 1:COND POLARIS
Practice Address - Street 2:2000 CARR 857 APT 208
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-8826
Practice Address - Country:US
Practice Address - Phone:787-405-1152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1429225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist