Provider Demographics
NPI:1013479187
Name:CASTILLO RODRIGUEZ, LILIANE (RBT)
Entity type:Individual
Prefix:
First Name:LILIANE
Middle Name:
Last Name:CASTILLO RODRIGUEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 SW 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-4507
Mailing Address - Country:US
Mailing Address - Phone:239-689-0286
Mailing Address - Fax:
Practice Address - Street 1:1513 SW 2ND CT
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6675
Practice Address - Country:US
Practice Address - Phone:786-972-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst