MEDICARE: BEATRIZ CRISTINA MEDINA CASTILLO

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	106S00000X	Behavior Technician		FL
2	106S00000X	Behavior Technician	M350063015550	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	:	1508483199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRIZ CRISTINA MEDINA CASTILLO

Provider Business Mailing Address
First Line	:	417 SE 9TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-5728
Country	:	US
Telephone Number	:	305-216-6133
Fax Number	:

Provider Business Practice Location Address
First Line	:	417 SE 9TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-5728
Country	:	US
Telephone Number	:	305-216-6133
Fax Number	:

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

Provider Enumeration Date	:	06/29/2020
Last Update Date	:	02/12/2026

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