Provider Demographics
NPI:1619072071
Name:CASTRO-RODRIGUEZ, NYDIA DE LOURDES (ND)
Entity Type:Individual
Prefix:
First Name:NYDIA
Middle Name:DE LOURDES
Last Name:CASTRO-RODRIGUEZ
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EL VEDADO URB #211 PEREZ GALDOS STREET
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3001
Mailing Address - Country:US
Mailing Address - Phone:787-485-3498
Mailing Address - Fax:
Practice Address - Street 1:EL VEDADO URB #211 PEREZ GALDOS STREET
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3001
Practice Address - Country:US
Practice Address - Phone:787-485-3498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16076208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice