Provider Demographics
NPI:1093464356
Name:CASTILLO RODRIGUEZ, ANEL
Entity Type:Individual
Prefix:
First Name:ANEL
Middle Name:
Last Name:CASTILLO RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5160 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1606
Mailing Address - Country:US
Mailing Address - Phone:786-915-2864
Mailing Address - Fax:
Practice Address - Street 1:5160 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-1606
Practice Address - Country:US
Practice Address - Phone:786-915-2864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLI263060975650374U00000X
FLC234000946370374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide