Provider Demographics
NPI:1891576278
Name:CASTILLO, RAFAEL MARIANO SR (RBT-23-270038)
Entity Type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:MARIANO
Last Name:CASTILLO
Suffix:SR
Gender:M
Credentials:RBT-23-270038
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18945 SW 256TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33031-1748
Mailing Address - Country:US
Mailing Address - Phone:316-312-8844
Mailing Address - Fax:
Practice Address - Street 1:18945 SW 256TH ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33031-1748
Practice Address - Country:US
Practice Address - Phone:316-312-8844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician