Provider Demographics
NPI:1447088091
Name:DIAZ CASTILLO, ISABEL
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:DIAZ 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 1:13332 SW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-7124
Mailing Address - Country:US
Mailing Address - Phone:305-339-4574
Mailing Address - Fax:
Practice Address - Street 1:13332 SW 28TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-7124
Practice Address - Country:US
Practice Address - Phone:305-339-4574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-363374103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst