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Individual

IDA M CASTA-MENDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
AVE ALBIZU CAMPOS #156 REPARTO LOPEZ, AGUADILLA, PR 00605
(787) 819-1305
(787) 819-1305
Mailing address
PO BOX 4164, AGUADILLA, PR 00605
(787) 819-1305
(787) 819-1305

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
3068
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1416
PREFERRED MEDICARE CHOICE
01
8000286
HUMANA
Enumeration date
06/21/2006
Last updated
07/08/2007
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