Provider Demographics
NPI:1831702992
Name:CASTRO, NENITA LLORCA (MD)
Entity type:Individual
Prefix:
First Name:NENITA
Middle Name:LLORCA
Last Name: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 1:1091 PORT MALABAR BLVD NE STE 1
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-5100
Mailing Address - Country:US
Mailing Address - Phone:321-728-7222
Mailing Address - Fax:
Practice Address - Street 1:1091 PORT MALABAR BLVD NE STE 1
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-5100
Practice Address - Country:US
Practice Address - Phone:321-728-7222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47154207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology