Healthcare Provider Details

I. General information

NPI: 1003589482
Provider Name (Legal Business Name): CELIA CASTILLO GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 GENEVIEVE DR
LEHIGH ACRES FL
33936-7561
US

IV. Provider business mailing address

595 GENEVIEVE DR
LEHIGH ACRES FL
33936-7561
US

V. Phone/Fax

Practice location:
  • Phone: 305-303-2515
  • Fax:
Mailing address:
  • Phone: 305-303-2515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT1317310
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-79068
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: