Provider Demographics
NPI:1437694916
Name:CASTILLO TROSSI, JOSE
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:CASTILLO TROSSI
Suffix:
Gender:M
Credentials:
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 1780
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00777
Mailing Address - Country:UM
Mailing Address - Phone:787-734-3591
Mailing Address - Fax:
Practice Address - Street 1:CALLE ERNESTO CADIZ
Practice Address - Street 2:#3
Practice Address - City:JUNCOS
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00777
Practice Address - Country:UM
Practice Address - Phone:787-734-3591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR015 NL175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath