Provider Demographics
NPI:1962114819
Name:SIVERIO, CASTOR GARCIA (ARNP)
Entity type:Individual
Prefix:MR
First Name:CASTOR
Middle Name:GARCIA
Last Name:SIVERIO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9781 NW 45TH LN
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3369
Mailing Address - Country:US
Mailing Address - Phone:786-238-8645
Mailing Address - Fax:
Practice Address - Street 1:7171 CORAL WAY STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1684
Practice Address - Country:US
Practice Address - Phone:786-238-8645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022727363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily