Provider Demographics
NPI:1740866938
Name:CASTRO, MICHAEL (LMT,CPT,ORT-ORTO)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:CASTRO
Suffix:
Gender:M
Credentials:LMT,CPT,ORT-ORTO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB COUNTRY CLUB CALLE ZAIDA 877
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-3307
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:URB COUNTRY CLUB CALLE ZAIDA 877
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-0092
Practice Address - Country:US
Practice Address - Phone:787-649-4930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist