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General NPI Number Information
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NPI Number | 1861849085
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Entity Type | Individual
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Provider Name | MARIA DECASTRO DNP
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Gender | Female
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 5802 E FOWLER AVE
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-3300
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Country | US
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Telephone | 813-442-7493
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Fax |
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Provider Business Mailing Address
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Address Line | 364 MINOLA DR
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-6034
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 878500
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN60581932
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61083966
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | GAA-NP000063
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11024650
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License Number State | FL
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