Healthcare Provider Details

I. General information

NPI: 1871300822
Provider Name (Legal Business Name): MIKELA CAHILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2024
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

922 23RD AVE E APT 214
TUSCALOOSA AL
35404-3072
US

IV. Provider business mailing address

922 23RD AVE E APT 214
TUSCALOOSA AL
35404-3072
US

V. Phone/Fax

Practice location:
  • Phone: 954-661-3371
  • Fax:
Mailing address:
  • Phone: 954-661-3371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: