Provider Demographics
NPI:1265885255
Name:CASTILLO, ASHLEY MELISSA
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MELISSA
Last Name: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 1:661 NE 4TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5010
Mailing Address - Country:US
Mailing Address - Phone:305-888-2711
Mailing Address - Fax:
Practice Address - Street 1:661 NE 4TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5010
Practice Address - Country:US
Practice Address - Phone:786-436-0693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
FL20197225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other