Provider Demographics
NPI:1194530865
Name:BARRIO CASTILLO, LISANDRA DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:LISANDRA
Middle Name:DE LA CARIDAD
Last Name:BARRIO CASTILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 NE 27TH TER UNIT 105
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7078
Mailing Address - Country:US
Mailing Address - Phone:786-969-4376
Mailing Address - Fax:
Practice Address - Street 1:383 NE 27TH TER UNIT 105
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7078
Practice Address - Country:US
Practice Address - Phone:786-969-4376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-408918106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician