Healthcare Provider Details

I. General information

NPI: 1467410498
Provider Name (Legal Business Name): MARGARITA OLIVARES CASTRO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 NEPTUNE RD
KISSIMMEE FL
34744-5272
US

IV. Provider business mailing address

1160 CYPRESS GLEN CIR
KISSIMMEE FL
34741-7560
US

V. Phone/Fax

Practice location:
  • Phone: 407-518-1074
  • Fax: 407-518-9056
Mailing address:
  • Phone: 407-518-1074
  • Fax: 407-518-9056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number043627
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number238013
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberME132170
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: