Provider Demographics
NPI:1295108785
Name:CASILLAS, XIOMARA (18055 RN)
Entity type:Individual
Prefix:MRS
First Name:XIOMARA
Middle Name:
Last Name:CASILLAS
Suffix:
Gender:F
Credentials:18055 RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC-1 BOX 4593
Mailing Address - Street 2:
Mailing Address - City:NAGUABO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00718
Mailing Address - Country:UM
Mailing Address - Phone:787-861-7777
Mailing Address - Fax:787-266-7318
Practice Address - Street 1:HC 1 BOX 4593
Practice Address - Street 2:
Practice Address - City:NAGUABO
Practice Address - State:PR
Practice Address - Zip Code:00718-9722
Practice Address - Country:US
Practice Address - Phone:787-861-7777
Practice Address - Fax:787-266-7318
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18055376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide