Provider Demographics
NPI:1467645754
Name:CASTILLO, RITA SOLEDAD (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:SOLEDAD
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RITA
Other - Middle Name:SOLEDAD
Other - Last Name:CASTILLO-CERVANTES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:107 GLENBROOK RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3001
Mailing Address - Country:US
Mailing Address - Phone:203-588-0600
Mailing Address - Fax:
Practice Address - Street 1:107 GLENBROOK RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3001
Practice Address - Country:US
Practice Address - Phone:203-588-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT045992207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology