Provider Demographics
NPI:1750902789
Name:CASTRO, LIUDMILA
Entity type:Individual
Prefix:
First Name:LIUDMILA
Middle Name:
Last Name:CASTRO
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 1:9986 SW 26TH ST # TH
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-5052
Mailing Address - Country:US
Mailing Address - Phone:954-470-4763
Mailing Address - Fax:
Practice Address - Street 1:9986 SW 26TH ST # TH
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-5052
Practice Address - Country:US
Practice Address - Phone:954-470-4763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician