Provider Demographics
NPI:1528269891
Name:RICMD GYN SERVICES P S C
Entity type:Organization
Organization Name:RICMD GYN SERVICES P S C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:I
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:787-868-2040
Mailing Address - Street 1:PO BOX 1539
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-1539
Mailing Address - Country:US
Mailing Address - Phone:787-831-7319
Mailing Address - Fax:787-868-2175
Practice Address - Street 1:115 RD KM 24.5 BO ASOMANTE
Practice Address - Street 2:AGUADA COMPLEX BUILDING SUITE G
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-868-2040
Practice Address - Fax:787-868-2175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7510207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty