Provider Demographics
NPI:1750039632
Name:GONZALEZ CASTILLO, DENYSSE
Entity Type:Individual
Prefix:
First Name:DENYSSE
Middle Name:
Last Name:GONZALEZ 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 1:5050 TAMIAMI TRL N STE B
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2853
Mailing Address - Country:US
Mailing Address - Phone:239-351-4666
Mailing Address - Fax:
Practice Address - Street 1:5050 TAMIAMI TRL N STE B
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2853
Practice Address - Country:US
Practice Address - Phone:239-351-4666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-22-206244106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician