Provider Demographics
NPI:1265210769
Name:CORRO DE CASTELLANO, HEYDY G
Entity type:Individual
Prefix:
First Name:HEYDY
Middle Name:G
Last Name:CORRO DE CASTELLANO
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 1:10410 W OKEECHOBEE RD APT 1107
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1920
Mailing Address - Country:US
Mailing Address - Phone:786-665-2540
Mailing Address - Fax:
Practice Address - Street 1:10410 W OKEECHOBEE RD APT 1107
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-1920
Practice Address - Country:US
Practice Address - Phone:786-665-2540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician