Individual
IVETTE CASTRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 VILLA DEL SOL CIR APT 104, ORLANDO, FL 32824-9461
(939) 277-7374
Mailing address
515 VILLA DEL SOL CIR APT 104, ORLANDO, FL 32824-9461
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
62016
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M535403788420
DRIVER LICENSE
FL
Enumeration date
07/24/2018
Last updated
07/24/2018
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