Individual provider Active NPI

Islleday Guevara Castro

  • Behavior Technician
  • Cape Coral, FL
National Provider Identifier
1982379863
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
20-132851 Issued in FL
Practice address
1320 SW 27TH Ter
Cape Coral, FL 33914-4170
Phone
(305) 342-2564
NPI assigned
Aug 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 20-132851 FL Primary

Addresses

Primary practice location

1320 SW 27TH Ter
Cape Coral, FL 33914-4170

Mailing address

1320 SW 27TH Ter
Cape Coral, FL 33914-4170
Phone (305) 342-2564

Other practice location 1

5365 NW 201st St
Miami Gardens, FL 33055-6623
Phone (305) 342-2564

Other identifiers 1

IdentifierTypeStateIssuer
110986400MedicaidFL

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
20-132851FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1982379863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 SW 27TH TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339144170",
            "telephone_number": "305-342-2564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 SW 27TH TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339144170",
            "telephone_number": "305-342-2564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5365 NW 201st St",
            "address_purpose": "LOCATION",
            "city": "Miami Gardens",
            "state": "FL",
            "postal_code": "330556623",
            "country_code": "US",
            "telephone_number": "305-342-2564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUEVARA CASTRO",
        "first_name": "ISLLEDAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "20-132851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110986400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.