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General NPI Number Information
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NPI Number | 1972192532
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Entity Type | Individual
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Provider Name | YAIMA SANTANA CASTELLANO
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Gender | Female
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Dates
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Enumeration Date | 01/18/2021
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 3611 SW 107TH AVE
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City | MIAMI
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State | FL
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Zip | 33165-3636
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Country | US
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Telephone | 305-763-4656
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Fax |
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Provider Business Mailing Address
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Address Line | 14257 SW 165TH ST
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City | MIAMI
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State | FL
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Zip | 33177-1834
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Country | US
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Telephone | 305-763-4656
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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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 101029
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License Number State | FL
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