Provider Demographics
NPI:1316254733
Name:CASTILLERO, YALILIS
Entity type:Individual
Prefix:
First Name:YALILIS
Middle Name:
Last Name:CASTILLERO
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 1:10755 SW 108TH AVE APT 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-8109
Mailing Address - Country:US
Mailing Address - Phone:305-728-9480
Mailing Address - Fax:
Practice Address - Street 1:10755 SW 108TH AVE APT 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8109
Practice Address - Country:US
Practice Address - Phone:305-728-9480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB12042426103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst