Basic Information
| Provider Information | |||||||||
| NPI: | 1144584731 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASTILLO | ||||||||
| FirstName: | ROBERTO | ||||||||
| MiddleName: | CARLOS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 OSTRUM ST STE 202 | ||||||||
| Address2: | |||||||||
| City: | FOUNTAIN HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180151152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845262200 | ||||||||
| FaxNumber: | 4845262398 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 OSTRUM ST STE 202 | ||||||||
| Address2: | |||||||||
| City: | FOUNTAIN HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845262200 | ||||||||
| FaxNumber: | 4845262398 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2012 | ||||||||
| LastUpdateDate: | 08/09/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0102X | 0116030235 | VA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | OS019386 | PA | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0102X | OS019386 | PA | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
No ID Information.