Provider Demographics
NPI:1427878875
Name:CASTILLO, DARA CARYL (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DARA
Middle Name:CARYL
Last Name:CASTILLO
Suffix:
Gender:
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 NE 5TH WAY
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-3261
Mailing Address - Country:US
Mailing Address - Phone:954-790-0869
Mailing Address - Fax:
Practice Address - Street 1:10301 HAGEN RANCH RD STE D720
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3777
Practice Address - Country:US
Practice Address - Phone:561-532-1462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035551363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health