Provider Demographics
NPI:1619938172
Name:COLON CASTILLO, LILLIAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:E
Last Name:COLON CASTILLO
Suffix:
Gender:F
Credentials:MD
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 366527
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:PR
Mailing Address - Country:UM
Mailing Address - Phone:787-765-7320
Mailing Address - Fax:787-756-7546
Practice Address - Street 1:570 CALLE B
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-1649
Practice Address - Country:US
Practice Address - Phone:787-765-7328
Practice Address - Fax:787-753-7656
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7112207ZN0500X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH-53336Medicare UPIN
PR002-0824Medicare ID - Type Unspecified