Provider Demographics
NPI:1225855752
Name:ALVARADO CASTELLANOS, ARLEN
Entity type:Individual
Prefix:
First Name:ARLEN
Middle Name:
Last Name:ALVARADO CASTELLANOS
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 1:2901 HYPOLUXO RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33462-3886
Mailing Address - Country:US
Mailing Address - Phone:561-679-7910
Mailing Address - Fax:
Practice Address - Street 1:2901 HYPOLUXO RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33462-3886
Practice Address - Country:US
Practice Address - Phone:561-679-7910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-372961106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty