Provider Demographics
NPI:1215986906
Name:CASTILLO, ROLANDO (LMHC)
Entity type:Individual
Prefix:
First Name:ROLANDO
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4544 SW 132ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3948
Mailing Address - Country:US
Mailing Address - Phone:305-775-6634
Mailing Address - Fax:
Practice Address - Street 1:3621 SW 107TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3636
Practice Address - Country:US
Practice Address - Phone:305-608-3383
Practice Address - Fax:786-534-7118
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH 6329101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL762635500Medicaid
FL1215986906Other1215986906
FL765962800Medicaid