Provider Demographics
NPI:1851810873
Name:CASTELBLANCO, FLORENCIA
Entity Type:Individual
Prefix:
First Name:FLORENCIA
Middle Name:
Last Name:CASTELBLANCO
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 1:65 THOMAS JOHNSON DR STE A
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4371
Mailing Address - Country:US
Mailing Address - Phone:301-662-3808
Mailing Address - Fax:
Practice Address - Street 1:932 HUNGERFORD DR STE 18A
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1751
Practice Address - Country:US
Practice Address - Phone:301-327-4434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
210002130OtherDISTRICT OF COLUMBIA DEPT. OF HEALTH: BOARD OF OCCUPATIONAL THERAPY
MD09813OtherMARYLAND BOARD OF OCCUPATIONAL THERAPY