MEDICARE: DR. ANNIE L CASTA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4164	WI
2	207QS0010X	Sports Medicine (Family Medicine) Physician	ME117614	FL
3	207Q00000X	Family Medicine Physician	ME117614	FL

General Provider Information

NPI Number	:	1194024695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNIE L CASTA M.D.

Provider Business Mailing Address
First Line	:	175 WESTWARD DR.
Second Line	:
City	:	MIAMI SPRING
State	:	FL
Zip	:	33166
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1060 SW 67TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-4754
Country	:	US
Telephone Number	:	786-353-2573
Fax Number	:	786-353-2587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2011
Last Update Date	:	12/19/2025

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Directions to “ DR. ANNIE L CASTA M.D.” Practice Location

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