Individual
PAOLA ELIZABETH MEDINA CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
2885 SE 1ST DR UNIT 1, HOMESTEAD, FL 33033-7261
(786) 678-8148
Mailing address
2885 SE 1ST DR UNIT 1, HOMESTEAD, FL 33033-7261
(786) 678-8148
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-19-10237
FL
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019814800
—
FL
Enumeration date
02/01/2017
Last updated
06/01/2023
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