Provider Demographics
NPI:1437913167
Name:CASTILLO, ADIS BELSY
Entity Type:Individual
Prefix:
First Name:ADIS
Middle Name:BELSY
Last Name: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 1:1121 SW 7TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3129
Mailing Address - Country:US
Mailing Address - Phone:305-857-7106
Mailing Address - Fax:
Practice Address - Street 1:1121 SW 7TH ST APT 4
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3129
Practice Address - Country:US
Practice Address - Phone:305-857-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-325950106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician