1508581018 NPI number — DR. ANGEL A CASTRO DNP,APRN,FNP

Table of content: DR. ANGEL A CASTRO DNP,APRN,FNP (NPI 1508581018)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508581018 NPI number — DR. ANGEL A CASTRO DNP,APRN,FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CASTRO
Provider First Name:
ANGEL
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DNP,APRN,FNP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508581018
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4161 W 2ND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33012-4421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-223-4600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1555 N KROME AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMESTEAD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33030-3232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-266-0222
Provider Business Practice Location Address Fax Number:
305-266-0848
Provider Enumeration Date:
10/06/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  11014778 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 11014778 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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