Healthcare Provider Details

I. General information

NPI: 1811826084
Provider Name (Legal Business Name): IRC BEHAVIOR THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 SW 3RD ST STE 114
CAPE CORAL FL
33991-1985
US

IV. Provider business mailing address

618 SW 3RD ST STE 114
CAPE CORAL FL
33991-1985
US

V. Phone/Fax

Practice location:
  • Phone: 786-507-9450
  • Fax:
Mailing address:
  • Phone: 786-507-9450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ILEANA RICARDO CASTRO
Title or Position: PRESIDENT
Credential:
Phone: 786-507-9450