Provider Demographics
NPI:1538114996
Name:JOSUE CASTILLO ROBLES
Entity Type:Organization
Organization Name:JOSUE CASTILLO ROBLES
Other - Org Name:JOSUE CASTILLO ROBLES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY LOU
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-259-8812
Mailing Address - Street 1:JARDINES DEL CARIBE
Mailing Address - Street 2:CALLE11 # 101
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-4405
Mailing Address - Country:US
Mailing Address - Phone:787-259-8812
Mailing Address - Fax:787-259-8812
Practice Address - Street 1:AVE. EDUARDO RUBERTE
Practice Address - Street 2:#15
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:787-259-8812
Practice Address - Fax:787-259-8812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR53517Medicare ID - Type Unspecified