Provider Demographics
NPI:1063964146
Name:MESA CASTILLO, DAYAMI (BCBA)
Entity type:Individual
Prefix:
First Name:DAYAMI
Middle Name:
Last Name:MESA CASTILLO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10341 NW 32ND PLACE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-5936
Mailing Address - Country:US
Mailing Address - Phone:786-660-5082
Mailing Address - Fax:
Practice Address - Street 1:10341 NW 32ND PLACE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-5936
Practice Address - Country:US
Practice Address - Phone:786-660-5082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-25
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLBCBA-1-20-41642103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113749600Medicaid