Provider Demographics
NPI:1184739567
Name:PEREZ-CASTRO, JOSEFINA (LCSW)
Entity type:Individual
Prefix:
First Name:JOSEFINA
Middle Name:
Last Name:PEREZ-CASTRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 SW 74TH CT
Mailing Address - Street 2:SUITE #104
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4452
Mailing Address - Country:US
Mailing Address - Phone:305-663-0013
Mailing Address - Fax:605-663-8138
Practice Address - Street 1:5001 SW 74TH CT
Practice Address - Street 2:SUITE #104
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4452
Practice Address - Country:US
Practice Address - Phone:305-663-0013
Practice Address - Fax:305-663-8138
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00013151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL650122068Medicare UPIN