Individual provider Active NPI

Ardee Tryll Castro, OTR/L

  • Occupational Therapist
  • Lake Wales, FL
National Provider Identifier
1982881272
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
10717 Issued in FL
Practice address
427 Burns Ave
Lake Wales, FL 33853-3314
Phone
(863) 679-3338
NPI assigned
Jan 29, 2008
Last updated
Nov 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 10717 FL Primary

Addresses

Primary practice location

427 Burns Ave
Lake Wales, FL 33853-3314

Mailing address

852 Blue Creek Dr
Haines City, FL 33844-9041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201015002803 FL Practitioner - Occupational Therapist in Private Practice 0042631061 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10717FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Pediatric Therapy, Inc. CurrentSince Apr 1, 2008 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Mar 3, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Mar 3, 2024 Accepting new patients
Dynamic Pediatric Therapy, Inc. Occupational Therapist PastSince Oct 24, 2021 Accepting new patients
Victory Ridge Academy, Inc. Occupational Therapist PastSince Nov 18, 2025 Accepting new patients

Locations

15600 SW 288th St
Ste 202
Homestead, FL 33033
Phone (305) 242-9424

600 NE 22nd Ter
Ste 205
Homestead, FL 33033
Phone (305) 242-9424

35 SE 1st Ave
Ste 20041
Ocala, FL 34471
Phone (800) 989-8080

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1982881272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "852 BLUE CREEK DR",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338449041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 BURNS AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338533314",
            "telephone_number": "863-679-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "ARDEE",
        "middle_name": "TRYLL",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "10717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.