Provider Demographics
NPI:1134616600
Name:CASTRO, LORRAINE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:CASTRO
Suffix:
Gender:
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9750 NW 33RD STREET
Mailing Address - Street 2:SUITE 209
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-509-3776
Mailing Address - Fax:954-827-0308
Practice Address - Street 1:9750 NW 33RD STREET
Practice Address - Street 2:SUITE 209
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-509-3776
Practice Address - Fax:954-827-0308
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
FLSA16230235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024883900Medicaid