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Mayra M. Casta

General Practice

Allopathic & Osteopathic Physicians

4700 N Habana Ave Ste 101, Tampa, FL 33614-7116

PECOS Enrollment

This provider is enrolled in PECOS as MAYRA CASTA.

Based on the most recent information from CMS, provider Mayra M. Casta is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1821046285
Provider Type
Individual
Full Name
Casta, Mayra M.
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
5/5/2006
Last Updated
3/23/2018

Contact Information

Practice Location

4700 N Habana Ave Ste 101, Tampa, FL 33614-7116

(813) 444-9599

(813) 513-8510

Mailing Location

6675 Westwood Blvd, Suite 475, Orlando, FL 32821-8061

(407) 845-0330

(888) 972-1752

Provider Taxonomies

Code	Description	License
Code 208D00000X Primary	Description General Practice Allopathic & Osteopathic Physicians	License ACN896 Florida
Code 208D00000X	Description General Practice Allopathic & Osteopathic Physicians	License 14334 Puerto Rico

Provider Identifiers

ID	Description	Issuer
ID 1508132	Description Other	Issuer WELLCARE
ID P01814157	Description Other	Issuer SIMPLY Florida
ID P1051219	Description Other	Issuer FEEDOM Florida
ID P983472	Description Other	Issuer OPTIMUM Florida
ID U1N7R	Description Other	Issuer FLORIDA BLUE Florida
ID 1145745	Description Other	Issuer CAREPLUS Florida

Mayra M. Casta

PECOS Enrollment

Profile Details

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