Provider Demographics
NPI:1588130678
Name:CASTRO, MARIA VICTORIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:VICTORIA
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 1:11905 SW 37TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3113
Mailing Address - Country:US
Mailing Address - Phone:786-306-4158
Mailing Address - Fax:
Practice Address - Street 1:11905 SW 37TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3113
Practice Address - Country:US
Practice Address - Phone:786-306-4158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-16
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL$$$$$$$$$OtherPERSONAL SUPPORT