Healthcare Provider Details

I. General information

NPI: 1104443647
Provider Name (Legal Business Name): KARINA G CASTILLO RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2020
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14808 SW 116TH AVE
MIAMI FL
33176
US

IV. Provider business mailing address

14808 SW 116TH AVE
MIAMI FL
33176-7375
US

V. Phone/Fax

Practice location:
  • Phone: 786-258-8499
  • Fax: 888-318-4788
Mailing address:
  • Phone: 786-355-0875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberIMH19483
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: