Healthcare Provider Details

I. General information

NPI: 1952136244
Provider Name (Legal Business Name): DAYANA MONTANO CASTRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8803 TAMIAMI TRL E
NAPLES FL
34113-3347
US

IV. Provider business mailing address

2872 50TH ST SW
NAPLES FL
34116-7624
US

V. Phone/Fax

Practice location:
  • Phone: 239-272-0838
  • Fax: 239-310-2045
Mailing address:
  • Phone: 239-367-3625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-368462
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: