Individual provider Active NPI

Luis Raul Gonzalez Castrodad, M.D.

  • Specialist
  • Manati, PR
National Provider Identifier
1366507287
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
7178 Issued in PR
Practice address
Hdez.Carrion St. # E -34
Manati Medical Center
Manati, PR 00674-0429
Phone
(787) 854-8000
NPI assigned
Dec 22, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7178 PR Primary

Addresses

Primary practice location

Hdez.Carrion St. # E -34
Manati Medical Center
Manati, PR 00674-0429

Mailing address

PO Box 429
Manati, PR 00674-0429
Phone (787) 505-6741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7178PRMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Womans Medical Services Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1366507287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 429",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006740429",
            "telephone_number": "787-505-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HDEZ.CARRION ST. # E -34",
            "address_2": "MANATI MEDICAL CENTER",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006740429",
            "telephone_number": "787-854-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ CASTRODAD",
        "first_name": "LUIS",
        "middle_name": "RAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "7178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.