Healthcare Provider Details

I. General information

NPI: 1083527824
Provider Name (Legal Business Name): GEORGETTE CASTRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1957 JACKSON ST
HOLLYWOOD FL
33020-5021
US

IV. Provider business mailing address

2706 KINSINGTON CIR
WESTON FL
33332-1859
US

V. Phone/Fax

Practice location:
  • Phone: 954-921-2600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: