Provider Demographics
NPI:1104686997
Name:CASTRO, ANASTASIA MARIA
Entity type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:MARIA
Last Name:CASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MANVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-3154
Mailing Address - Country:US
Mailing Address - Phone:419-785-5118
Mailing Address - Fax:
Practice Address - Street 1:200 MANVILLE AVE
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-3154
Practice Address - Country:US
Practice Address - Phone:419-785-5118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care