Provider Demographics
NPI:1528264702
Name:CASTILLO BEAUCHAMP, YAMIL E (MD)
Entity type:Individual
Prefix:
First Name:YAMIL
Middle Name:E
Last Name:CASTILLO BEAUCHAMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:425 CARR 693
Mailing Address - Street 2:PMB 384
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-0000
Mailing Address - Country:US
Mailing Address - Phone:787-621-4816
Mailing Address - Fax:
Practice Address - Street 1:MANATI MEDICAL CENTER PROFESSIONAL PLAZA SUITE 504
Practice Address - Street 2:CALLE HERNANDEZ CARRION
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-0000
Practice Address - Country:US
Practice Address - Phone:787-621-4816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR18258208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR18258OtherMEDICAL LICENSE