Healthcare Provider Details

I. General information

NPI: 1083255913
Provider Name (Legal Business Name): JAILYN CASTRO GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 10TH AVE N STE 2115
LAKE WORTH BEACH FL
33461-3345
US

IV. Provider business mailing address

4116 SELBERG LN
LAKE WORTH FL
33461-4354
US

V. Phone/Fax

Practice location:
  • Phone: 561-506-3665
  • Fax: 561-444-2458
Mailing address:
  • Phone: 786-716-4169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number12690043
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: