Provider Demographics
NPI:1356114615
Name:CASTELLON RUMBAUT, YENISY C
Entity type:Individual
Prefix:
First Name:YENISY
Middle Name:C
Last Name:CASTELLON RUMBAUT
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 1:26710SW 140TH AVE
Mailing Address - Street 2:APT 308
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032
Mailing Address - Country:US
Mailing Address - Phone:786-499-2913
Mailing Address - Fax:
Practice Address - Street 1:26710SW 140TH AVE
Practice Address - Street 2:APT 308
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032
Practice Address - Country:US
Practice Address - Phone:786-499-2913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-23-297585OtherBEHAVIOR ANALYST CERTIFICATION BOARD
FL120381600Medicaid