Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | ME117614 | FL |
N | 207QS0010X | Family Doctor - Sports Medicine | ME117614 | FL |
NPI | 1194024695 |
---|---|
Provider Name | Dr. Annie L Casta |
First Address | Miami Spring, FL 33166 |
Second Address | Miami Springs, FL 33166 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2011 |
Last Update Date | 04/02/2022 |