Provider Demographics
NPI:1275240970
Name:SANCHEZ CASTILLO, ROXANA MARIA
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:MARIA
Last Name:SANCHEZ CASTILLO
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 1:15741 SW 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1618
Mailing Address - Country:US
Mailing Address - Phone:786-614-6044
Mailing Address - Fax:
Practice Address - Street 1:15741 SW 100TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1618
Practice Address - Country:US
Practice Address - Phone:786-614-6044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-22241293106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician