Provider Demographics
NPI:1417616004
Name:DR VALENTINO CASTRO
Entity Type:Organization
Organization Name:DR VALENTINO CASTRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VALENTINO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:941-448-9115
Mailing Address - Street 1:5700 BAYSHORE RD LOT 711
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-9356
Mailing Address - Country:US
Mailing Address - Phone:941-448-9115
Mailing Address - Fax:
Practice Address - Street 1:5700 BAYSHORE RD LOT 711
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-9356
Practice Address - Country:US
Practice Address - Phone:941-448-9115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-11
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOL072Medicaid