Provider Demographics
NPI:1417354879
Name:CASTRO CHANDRI, JOSE F (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:F
Last Name:CASTRO CHANDRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 CALLE SAN GUILLERMO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6551
Mailing Address - Country:US
Mailing Address - Phone:787-630-2884
Mailing Address - Fax:
Practice Address - Street 1:400 FD. ROOSELVELT AVE
Practice Address - Street 2:CLINICA LAS AMERICAS SUITE #405
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-250-8090
Practice Address - Fax:787-281-8308
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18944208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice