MEDICARE: MRS. KELSEY JOY CASTROVERDE

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11028494	FL
2	163W00000X	Registered Nurse	RN9461089	FL

General Provider Information

NPI Number	:	1477262442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELSEY JOY CASTROVERDE

Provider Business Mailing Address
First Line	:	12239 REBECCAS RUN DR
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-5529
Country	:	US
Telephone Number	:	407-451-3116
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 W COLONIAL DR STE 104
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6863
Country	:	US
Telephone Number	:	407-392-9244
Fax Number	:	407-569-9244

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

Provider Enumeration Date	:	11/18/2022
Last Update Date	:	02/02/2026

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