Provider Demographics
NPI:1568203644
Name:LAGUNA CASTRO, JUDITH
Entity type:Individual
Prefix:MISS
First Name:JUDITH
Middle Name:
Last Name:LAGUNA CASTRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:LAGUNA CASTRO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JUDITH LAGUNA CASTRO
Mailing Address - Street 1:6244 NW 171ST ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4611
Mailing Address - Country:US
Mailing Address - Phone:305-215-4666
Mailing Address - Fax:
Practice Address - Street 1:9509 W FLAGLER ST STE 18
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2012
Practice Address - Country:US
Practice Address - Phone:305-215-4666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA97132225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist