Provider Demographics
NPI:1649693029
Name:CASTRO, SARA SOFIA (CONSULTANT PHARMACIS)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:SOFIA
Last Name:CASTRO
Suffix:
Gender:F
Credentials:CONSULTANT PHARMACIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8925 LEE VISTA BLVD
Mailing Address - Street 2:APT 2706
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-8354
Mailing Address - Country:US
Mailing Address - Phone:407-409-1039
Mailing Address - Fax:
Practice Address - Street 1:8925 LEE VISTA BLVD
Practice Address - Street 2:APT 2706
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32829-8354
Practice Address - Country:US
Practice Address - Phone:407-409-1039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU 6185183500000X
FLPS 34988183500000X
CARPH 68833183500000X
NY039732183500000X
AZ11391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist