Provider Demographics
NPI:1174063754
Name:CASTRO, IRIS DANIA
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:DANIA
Last Name:CASTRO
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 1:8015 NW 8TH ST APT 306
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2857
Mailing Address - Country:US
Mailing Address - Phone:786-449-1950
Mailing Address - Fax:
Practice Address - Street 1:8015 NW 8TH ST APT 306
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2857
Practice Address - Country:US
Practice Address - Phone:786-449-1950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician