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General NPI Number Information
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NPI Number | 1164950895
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Entity Type | Individual
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Provider Name | DANITZA CASTILLO RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 05/25/2017
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 2630 NE 3RD DR UNIT 102
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City | HOMESTEAD
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State | FL
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Zip | 33033-7031
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Country | US
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Telephone | 407-912-6608
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Fax |
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Provider Business Mailing Address
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Address Line | 2630 NE 3RD DR
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City | HOMESTEAD
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State | FL
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Zip | 33033-7030
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Country | US
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Telephone | 407-912-6608
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-18-61708
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-20-44635
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License Number State | FL
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