Individual provider Active NPI

Karen Matilde Medina Castro

  • Registered Nurse
  • Kissimmee, FL
National Provider Identifier
1487336632
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
9484459 Issued in FL
Practice address
2219 Canyon Breeze Ave
Kissimmee, FL 34746-2317
Phone
(407) 791-6076
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9484459 FL Primary

Addresses

Primary practice location

2219 Canyon Breeze Ave
Kissimmee, FL 34746-2317

Mailing address

2219 Canyon Breeze Ave
Kissimmee, FL 34746-2317
Phone (407) 791-6076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9484459FLMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1487336632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 CANYON BREEZE AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462317",
            "telephone_number": "407-791-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 CANYON BREEZE AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347462317",
            "telephone_number": "407-791-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA CASTRO",
        "first_name": "KAREN",
        "middle_name": "MATILDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9484459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.