Healthcare Provider Details

I. General information

NPI: 1376459198
Provider Name (Legal Business Name): DIANA PATRICIA CASTRO JARAMILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9654 RIVER RD
SPRING HILL FL
34608-3864
US

IV. Provider business mailing address

9654 RIVER RD
SPRING HILL FL
34608-3864
US

V. Phone/Fax

Practice location:
  • Phone: 813-521-1261
  • Fax:
Mailing address:
  • Phone: 813-521-1261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA105938
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: