Provider Demographics
NPI:1497207591
Name:CASTRO, JARED (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:
Last Name:CASTRO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 TURNER ST BLDG 3600
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32508-5211
Mailing Address - Country:US
Mailing Address - Phone:850-452-5245
Mailing Address - Fax:
Practice Address - Street 1:450 TURNER ST BLDG 3600
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32508-5211
Practice Address - Country:US
Practice Address - Phone:850-452-5245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant