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NPI Code Detail

MEDICARE: YORDAN CASTILLO

MEDICARE:   YORDAN  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
1106S00000XBehavior TechnicianRBT21157337FL

Other Identifiers

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

General Provider Information

NPI Number : 1669183836
Entity Type Code : Individual
Provider Name (Legal Business Name) : YORDAN CASTILLO
Provider Business Mailing Address
First Line : 3822 NW 46TH ST
Second Line :
City : CAPE CORAL
State : FL
Zip : 33993-7948
Country : US
Telephone Number : 786-860-7384
Fax Number :
Provider Business Practice Location Address
First Line : 3822 NW 46TH ST
Second Line :
City : CAPE CORAL
State : FL
Zip : 33993-7948
Country : US
Telephone Number : 786-860-7384
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2022
Last Update Date : 09/08/2023

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Directions to “ YORDAN CASTILLO ” Practice Location

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