Individual
ADRIA MARIA CASTILLO SOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4880 NW 177TH ST, MIAMI GARDENS, FL 33055-3646
(786) 340-4722
Mailing address
4880 NW 177TH ST, MIAMI GARDENS, FL 33055-3646
(786) 340-4722
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-35537
FL
106S00000X
Behavior Technician
16-23259
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982045290
—
FL
Enumeration date
05/23/2016
Last updated
04/05/2019
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