Healthcare Provider Details

I. General information

NPI: 1932978681
Provider Name (Legal Business Name): PEDRO MIGUEL CASTRO DUQUE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18951 SW 106TH AVE STE 105-106
CUTLER BAY FL
33157-7668
US

IV. Provider business mailing address

4590 W 8TH AVE
HIALEAH FL
33012-3504
US

V. Phone/Fax

Practice location:
  • Phone: 305-233-4448
  • Fax:
Mailing address:
  • Phone: 305-942-5434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-314689
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2843494
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: