Provider Demographics
NPI:1932965720
Name:CASTANO, ALBA LILIANA
Entity Type:Individual
Prefix:
First Name:ALBA
Middle Name:LILIANA
Last Name:CASTANO
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 1:4728 CARROWAY DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-6415
Mailing Address - Country:US
Mailing Address - Phone:813-479-8919
Mailing Address - Fax:
Practice Address - Street 1:4728 CARROWAY DR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-6415
Practice Address - Country:US
Practice Address - Phone:813-479-8919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician