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General NPI Number Information
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NPI Number | 1265885255
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Entity Type | Individual
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Provider Name | ASHLEY MELISSA CASTILLO
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Gender | Female
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 08/10/2019
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Provider Practice Location Address
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Address Line | 661 NE 4TH PL
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City | HIALEAH
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State | FL
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Zip | 33010-5010
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Country | US
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Telephone | 786-436-0693
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Fax |
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Provider Business Mailing Address
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Address Line | 661 NE 4TH PL
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City | HIALEAH
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State | FL
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Zip | 33010-5010
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Country | US
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Telephone | 305-888-2711
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 20197
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License Number State | FL
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