Provider Demographics
NPI:1255894473
Name:SEIFE CASTILLO, ROSA MARIA SR
Entity type:Individual
Prefix:MS
First Name:ROSA
Middle Name:MARIA
Last Name:SEIFE CASTILLO
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 1:703 GORDON AVE N
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-1134
Mailing Address - Country:US
Mailing Address - Phone:305-879-2670
Mailing Address - Fax:
Practice Address - Street 1:703 GORDON AVE N
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1134
Practice Address - Country:US
Practice Address - Phone:305-879-2670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-14
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-116972106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician