Healthcare Provider Details

I. General information

NPI: 1760351845
Provider Name (Legal Business Name): KAYLA CHARLAND CF SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8777 SAN JOSE BLVD STE 701
JACKSONVILLE FL
32217-4292
US

IV. Provider business mailing address

8777 SAN JOSE BLVD STE 701
JACKSONVILLE FL
32217-4292
US

V. Phone/Fax

Practice location:
  • Phone: 904-733-8255
  • Fax: 904-733-5034
Mailing address:
  • Phone: 904-733-8255
  • Fax: 904-733-4503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ13118
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: