MEDICARE: JAILYN CASTRO GARCIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst
2	103K00000X	Behavior Analyst	12690043	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083255913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAILYN CASTRO GARCIA

Provider Business Mailing Address
First Line	:	4116 SELBERG LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4354
Country	:	US
Telephone Number	:	786-716-4169
Fax Number	:

Provider Business Practice Location Address
First Line	:	2115 10TH AVE N STE 2115
Second Line	:
City	:	LAKE WORTH BEACH
State	:	FL
Zip	:	33461-3345
Country	:	US
Telephone Number	:	561-506-3665
Fax Number	:	561-444-2458

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2019
Last Update Date	:	05/18/2026

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