MEDICARE: LAREISY GUZMAN 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	RBT-25-454954	FL

General Provider Information

NPI Number	:	1952283749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAREISY GUZMAN CASTILLO

Provider Business Mailing Address
First Line	:	2478 PINEWAY DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-7229
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2478 PINEWAY DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-7229
Country	:	US
Telephone Number	:	702-421-7138
Fax Number	:

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

Provider Enumeration Date	:	07/23/2025
Last Update Date	:	07/23/2025

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