Provider Demographics
NPI:1942718135
Name:MATTES DEL CASTILLO, HAYDEE
Entity Type:Individual
Prefix:
First Name:HAYDEE
Middle Name:
Last Name:MATTES DEL 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 1:1200 NE MIAMI GARDENS DR APT 215
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4710
Mailing Address - Country:US
Mailing Address - Phone:786-260-1967
Mailing Address - Fax:
Practice Address - Street 1:1200 NE MIAMI GARDENS DR APT 215
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4710
Practice Address - Country:US
Practice Address - Phone:786-260-1967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-22
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician