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General NPI Number Information
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NPI Number | 1871444646
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Entity Type | Organization
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Legal Business Name | DIVERSE HEALTHCARE & PHARMACY GROUP, LLC
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 8040 NW 95TH ST STE 223-224
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2362
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Country | US
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Telephone | 786-703-7828
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Fax |
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Provider Business Mailing Address
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Address Line | 8040 NW 95TH ST STE 223-224
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City | HIALEAH GARDENS
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State | FL
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Zip | 33016-2362
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Country | US
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Telephone | 786-703-7828
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Fax |
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Authorized Official
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Title or Position | CEO/CO-FOUNDER
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Name | AUXILIADORA CASTRO
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Credential |
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Telephone | 305-305-2785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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