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General NPI Number Information
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NPI Number | 1770126815
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Entity Type | Individual
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Provider Name | ZEIDA CASTILLO DIAZ M.S.
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Gender | Female
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 11/17/2024
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Provider Practice Location Address
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Address Line | 5757 WATERFORD DISTRICT DR STE 172
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City | MIAMI
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State | FL
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Zip | 33126-2076
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Country | US
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Telephone | 786-353-2616
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Fax | 786-524-2880
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Provider Business Mailing Address
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Address Line | 5757 WATERFORD DISTRICT DR STE 172
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City | MIAMI
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State | FL
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Zip | 33126-2076
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Country | US
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Telephone | 786-353-2616
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Fax | 786-524-2880
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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 | 104100000X
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Taxonomy Name | Social Worker
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | CBHCMS100987
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License Number State | FL
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