Healthcare Provider Details

I. General information

NPI: 1588439228
Provider Name (Legal Business Name): LIANET CASTELLANOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8395 W OAKLAND PARK BLVD STE A
SUNRISE FL
33351-7301
US

IV. Provider business mailing address

13880 SW 44TH TER
MIAMI FL
33175-3770
US

V. Phone/Fax

Practice location:
  • Phone: 866-330-9025
  • Fax:
Mailing address:
  • Phone: 786-310-8960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: