Healthcare Provider Details

I. General information

NPI: 1851810873
Provider Name (Legal Business Name): FLORENCIA CASTELBLANCO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 HUNGERFORD DR STE 18A
ROCKVILLE MD
20850-1751
US

IV. Provider business mailing address

65 THOMAS JOHNSON DR STE A
FREDERICK MD
21702-4371
US

V. Phone/Fax

Practice location:
  • Phone: 301-327-4434
  • Fax:
Mailing address:
  • Phone: 301-662-3808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: