Provider Demographics
NPI:1528755204
Name:CASTILLO VERDECIA, ERLEN EVELIA SR
Entity type:Individual
Prefix:
First Name:ERLEN
Middle Name:EVELIA
Last Name:CASTILLO VERDECIA
Suffix:SR
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 1:9817 PINEY POINT CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-6549
Mailing Address - Country:US
Mailing Address - Phone:321-276-3631
Mailing Address - Fax:
Practice Address - Street 1:2901 E IRLO BRONSON MEMORIAL HWY STE D
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5600
Practice Address - Country:US
Practice Address - Phone:407-483-4750
Practice Address - Fax:407-201-6260
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician