Provider Demographics
NPI:1689216780
Name:CASTILLO PEREZ, YOSLAY
Entity Type:Individual
Prefix:
First Name:YOSLAY
Middle Name:
Last Name:CASTILLO PEREZ
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 1:305 NW 72ND AVE APT 409
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4380
Mailing Address - Country:US
Mailing Address - Phone:786-317-9269
Mailing Address - Fax:
Practice Address - Street 1:1607 PONCE DE LEON BLVD STE 111
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4035
Practice Address - Country:US
Practice Address - Phone:786-317-9269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004523363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily