Healthcare Provider Details

I. General information

NPI: 1003647116
Provider Name (Legal Business Name): DAYANIRA ALVAREZ CASTILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 PINAFORE AVE
LEHIGH ACRES FL
33974-2443
US

IV. Provider business mailing address

347 PINAFORE AVE
LEHIGH ACRES FL
33974-2443
US

V. Phone/Fax

Practice location:
  • Phone: 561-412-8325
  • Fax:
Mailing address:
  • Phone: 561-412-8325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-368816
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2837468
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: