Provider Demographics
NPI:1205004454
Name:CASTO, AIDA M (ARNP)
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:M
Last Name:CASTO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AIDA
Other - Middle Name:M
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2382 CRAWFORDVILLE HWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32327-1034
Mailing Address - Country:US
Mailing Address - Phone:850-926-6363
Mailing Address - Fax:850-926-2602
Practice Address - Street 1:2382 CRAWFORDVILLE HWY
Practice Address - Street 2:SUITE C
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-1034
Practice Address - Country:US
Practice Address - Phone:850-926-6363
Practice Address - Fax:850-926-2602
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1574602363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00480555OtherRR MEDICARE
FLP00480555OtherRR MEDICARE
FLAJ148ZMedicare PIN