Provider Demographics
NPI:1467410498
Name:OLIVARES CASTRO, MARGARITA (MD)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:OLIVARES CASTRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 CYPRESS GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7560
Mailing Address - Country:US
Mailing Address - Phone:407-518-1074
Mailing Address - Fax:407-518-9056
Practice Address - Street 1:13 NEPTUNE RD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5272
Practice Address - Country:US
Practice Address - Phone:407-518-1074
Practice Address - Fax:407-518-9056
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043627207V00000X
NY238013207VX0000X
FLME132170207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME132170OtherMEDICAL LICENSE
CT001436270Medicaid
CO043627OtherSTATE LICENSE