Provider Demographics
NPI:1013770767
Name:CASTRO BOADA, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CASTRO BOADA
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 1:508 CORINNE DR
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-7515
Mailing Address - Country:US
Mailing Address - Phone:239-922-3790
Mailing Address - Fax:
Practice Address - Street 1:508 CORINNE DR
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-7515
Practice Address - Country:US
Practice Address - Phone:239-922-3790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician