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General NPI Number Information
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NPI Number | 1578336145
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Entity Type | Individual
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Provider Name | BIANCA ALEXIS CASTILLO
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Gender | Female
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 2406 COMMERCIAL WAY
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City | SPRING HILL
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State | FL
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Zip | 34606-3518
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Country | US
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Telephone | 352-835-7128
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Fax |
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Provider Business Mailing Address
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Address Line | 9136 HERMITAGE LN
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City | PORT RICHEY
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State | FL
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Zip | 34668-5187
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Country | US
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Telephone | 813-730-9075
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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 | 2355A2700X
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Taxonomy Name | Audiology Assistant
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License Number | AI425
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS5765
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License Number State | FL
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