Provider Demographics
NPI:1609330265
Name:CASTILLO, KARINA NO MIDDLE NAME
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:NO MIDDLE NAME
Last Name: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 1:9507 SW 160TH ST STE 250
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3373
Mailing Address - Country:US
Mailing Address - Phone:973-510-8270
Mailing Address - Fax:
Practice Address - Street 1:9507 SW 160TH ST STE 250
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-3373
Practice Address - Country:US
Practice Address - Phone:973-510-8270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician