Healthcare Provider Details

I. General information

NPI: 1700441235
Provider Name (Legal Business Name): LIZMARIE TIRADO CASTRO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 08/17/2025
Certification Date: 08/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 SW ARCHER RD
GAINESVILLE FL
32608-1134
US

IV. Provider business mailing address

201 SETON PKWY
ROUND ROCK TX
78665-8000
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberW0754
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: