Healthcare Provider Details

I. General information

NPI: 1811554231
Provider Name (Legal Business Name): ESTELA D RODRIGUEZ CASTRO BCBA, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 S DEANE DUFF AVE UNIT 2
CLEWISTON FL
33440-3847
US

IV. Provider business mailing address

141 S DEANE DUFF AVE UNIT 2
CLEWISTON FL
33440-3847
US

V. Phone/Fax

Practice location:
  • Phone: 786-420-8999
  • Fax:
Mailing address:
  • Phone: 786-420-8999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-46098
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN9430049
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: