Individual provider Active NPI

Brandon Castillo, BCBA

  • Behavior Analyst
  • Davie, FL
National Provider Identifier
1982058996
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11621678 Issued in FL
Practice address
5400 S University Dr Ste 502
Davie, FL 33328-5313
Phone
(954) 824-1487
NPI assigned
Apr 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 11621678 FL Primary

Addresses

Primary practice location

5400 S University Dr Ste 502
Davie, FL 33328-5313

Mailing address

5400 S University Dr Ste 502
Davie, FL 33328-5313
Phone (954) 824-1487

Other practice location 1

3650 NW 8th Street
Suite 109
Sunrise, FL 33325
Phone (954) 824-1487

Other identifiers 1

IdentifierTypeStateIssuer
11621678OtherFLLIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11621678FLMDBehavioral Analyst

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1982058996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DR STE 502",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285313",
            "telephone_number": "954-824-1487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DR STE 502",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285313",
            "telephone_number": "954-824-1487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3650 NW 8th Street",
            "address_2": "Suite 109",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "33325",
            "country_code": "US",
            "telephone_number": "954-824-1487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "BRANDON",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "11621678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "11621678",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.