Provider Demographics
NPI:1285383471
Name:CASTRO BUENAVENTURA, MARIA ALEJANDRA
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ALEJANDRA
Last Name:CASTRO BUENAVENTURA
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 1:3625 ALAFAYA HEIGHTS RD UNIT 201
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7534
Mailing Address - Country:US
Mailing Address - Phone:407-907-8593
Mailing Address - Fax:
Practice Address - Street 1:3200 S HIAWASSEE RD STE 203
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6317
Practice Address - Country:US
Practice Address - Phone:407-490-1453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician