Provider Demographics
NPI:1265581854
Name:CASTRO-TOLEDO, JOEL
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:
Last Name:CASTRO-TOLEDO
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:PO BOX 141176
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-1176
Mailing Address - Country:US
Mailing Address - Phone:787-510-8184
Mailing Address - Fax:
Practice Address - Street 1:AVE JOSE A CEDENO
Practice Address - Street 2:ARECIBO SHOPPING CENTER SUITE #6
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-880-3362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3511152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRU95208Medicare UPIN
PR58162Medicare ID - Type Unspecified