Basic Information
| Provider Information | |||||||||
| NPI: | 1427519164 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CASAS LOYOLA | ||||||||
| FirstName: | CRISTINA | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | URB. TURABO GARDEN CARR. 172 (14.14 MI) | ||||||||
| Address2: | |||||||||
| City: | CAGUAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877433038 | ||||||||
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| Practice Location | |||||||||
| Address1: | HOSPITAL UNIVERSITARIO DE ADULTOS | ||||||||
| Address2: | CENTRO MEDICO | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877540101 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2019 | ||||||||
| LastUpdateDate: | 02/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 15571I | PR | N | Allopathic & Osteopathic Physicians | General Practice | 207R00000X | 35698 | PR | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 6048757 | 01 | PR | DRIVERS LICENSE | OTHER |