Provider Demographics
NPI:1760863757
Name:MAYMI-CASTRODAD, PATRICIA N (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:N
Last Name:MAYMI-CASTRODAD
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 1:100 PASEO SAN PABLO STE 410
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7028
Mailing Address - Country:US
Mailing Address - Phone:787-780-0970
Mailing Address - Fax:787-780-1660
Practice Address - Street 1:100 PASEO SAN PABLO STE 410
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7028
Practice Address - Country:US
Practice Address - Phone:787-780-0970
Practice Address - Fax:787-780-1660
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351047413208800000X
390200000X
PR23002208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program