Healthcare Provider Details

I. General information

NPI: 1083191936
Provider Name (Legal Business Name): LUCIA MARIA CASTRO HERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N 35TH AVE STE 170
HOLLYWOOD FL
33021-5424
US

IV. Provider business mailing address

2900 N COMMERCE PKWY
MIRAMAR FL
33025-3959
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-4325
  • Fax: 954-965-6388
Mailing address:
  • Phone: 954-276-5603
  • Fax: 954-965-6388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME184465
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: