Individual provider Active NPI

Alexandra Rachel Castillo

  • Nurse Practitioner
  • Hollywood, FL
National Provider Identifier
1639797426
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARPN11009457 Issued in FL
Practice address
3700 Washington St Ste a
Hollywood, FL 33021-8256
Phone
(954) 989-4700
NPI assigned
Jul 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN11009457 FL
Medical-Surgical Registered Nurse 163WM0705X RN9435328 FL
Nurse Practitioner 363L00000X ARPN11009457 FL Primary

Addresses

Primary practice location

3700 Washington St Ste a
Hollywood, FL 33021-8256

Mailing address

455 SW 200TH Ter
Pembroke Pines, FL 33029-1247
Phone (954) 665-3374

Other practice location 1

455 SW 200th Ter
Pembroke Pines, FL 33029-1247
Phone (954) 665-3374

Other practice location 2

11200 SW 8th St
Miami, FL 33199-2516
Phone (954) 665-3374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220908003760 FL Practitioner - Nurse Practitioner 7214311398 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9435328FLMDMedical-Surgical Registered Nurse
ARPN11009457FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Healthcare System CurrentSince May 20, 2022 Accepting new patients

Locations

3700 Washington St
Ste 500A
Hollywood, FL 33021
Phone (954) 633-7858

2213 N University Dr
Pembroke Pines, FL 33024
Phone (954) 963-2151

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1639797426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SW 200TH TER",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330291247",
            "telephone_number": "954-665-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON ST STE A",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330218256",
            "telephone_number": "954-989-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 SW 200th Ter",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330291247",
            "country_code": "US",
            "telephone_number": "954-665-3374",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11200 SW 8th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331992516",
            "country_code": "US",
            "telephone_number": "954-665-3374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "ALEXANDRA",
        "middle_name": "RACHEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "APRN11009457",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "FL",
            "license": "RN9435328",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARPN11009457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.