Provider Demographics
NPI:1215508163
Name:CASTILLO MONTILLA, ISABEL CRISTINA
Entity type:Individual
Prefix:MS
First Name:ISABEL
Middle Name:CRISTINA
Last Name:CASTILLO MONTILLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 KELSO DUNES AVE APT 411
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-7837
Mailing Address - Country:US
Mailing Address - Phone:407-360-6274
Mailing Address - Fax:
Practice Address - Street 1:1350 KELSO DUNES AVE APT 411
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7837
Practice Address - Country:US
Practice Address - Phone:407-360-6274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner