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Organization
GYDL ENTERPRISE
Active
Organization
GYDL ENTERPRISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLADYS CASTILLO-HERNANDEZ (OWNER)
(201) 705-2282
Entity
Organization
Contact information
Practice address
483 HALLCREST TERRACE, PORT CHARLOTTE, FL 33954-3736
(207) 705-2282
Mailing address
483 HALLCREST TERRACE, PORT CHARLOTTE, FL 33954-3736
(207) 705-2282
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023574700
—
FL
Enumeration date
05/15/2024
Last updated
10/30/2024
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