Provider Demographics
NPI:1376707786
Name:CASTORO, ANA L (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:L
Last Name:CASTORO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:L
Other - Last Name:CARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:303 N CLYDE MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2709
Mailing Address - Country:US
Mailing Address - Phone:386-226-4590
Mailing Address - Fax:386-226-3371
Practice Address - Street 1:2090 SAXON BLVD STE B
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-3251
Practice Address - Country:US
Practice Address - Phone:386-425-3300
Practice Address - Fax:386-425-3301
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN51876207Q00000X
FLME110515207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP00873576OtherRAILROAD MEDICARE
FL003898000Medicaid
FL003898000Medicaid