Provider Demographics
NPI:1568240588
Name:HERNANDEZ CASTILLO, AMALIA
Entity type:Individual
Prefix:
First Name:AMALIA
Middle Name:
Last Name:HERNANDEZ 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 1:8850 FONTAINEBLEAU BLVD APT 401
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-4454
Mailing Address - Country:US
Mailing Address - Phone:305-922-9247
Mailing Address - Fax:
Practice Address - Street 1:8850 FONTAINEBLEAU BLVD APT 401
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4454
Practice Address - Country:US
Practice Address - Phone:305-922-9247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-20
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225A00000X
FLRBT-23-289592106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist