Provider Demographics
NPI:1508581018
Name:CASTRO, ANGEL (DNP,APRN,FNP)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:
Last Name:CASTRO
Suffix:
Gender:F
Credentials:DNP,APRN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4161 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4421
Mailing Address - Country:US
Mailing Address - Phone:786-223-4600
Mailing Address - Fax:
Practice Address - Street 1:760 PONCE DE LEON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2076
Practice Address - Country:US
Practice Address - Phone:305-883-2940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11014778363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily