Provider Demographics
NPI:1679843320
Name:ADRIANA M CASTRO MD PA
Entity Type:Organization
Organization Name:ADRIANA M CASTRO MD PA
Other - Org Name:ADRIANA M CASTRO MD PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIVISION MANAGER
Authorized Official - Prefix:PROF
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:F
Authorized Official - Last Name:D'ASCOLI
Authorized Official - Suffix:II
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-275-1700
Mailing Address - Street 1:9220 SW 72ND ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3259
Mailing Address - Country:US
Mailing Address - Phone:305-275-1700
Mailing Address - Fax:305-275-5008
Practice Address - Street 1:9220 SW 72ND ST
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3259
Practice Address - Country:US
Practice Address - Phone:305-275-1700
Practice Address - Fax:305-275-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0056180208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063952400Medicaid
FLF33581Medicare UPIN