Healthcare Provider Details

I. General information

NPI: 1679478721
Provider Name (Legal Business Name): RICARDO ANTONIO CASTRO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3603 20TH ST SW
LEHIGH ACRES FL
33976-3406
US

IV. Provider business mailing address

3603 20TH ST SW
LEHIGH ACRES FL
33976-3406
US

V. Phone/Fax

Practice location:
  • Phone: 305-376-1032
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-285790
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: