Healthcare Provider Details

I. General information

NPI: 1316571284
Provider Name (Legal Business Name): CHEILA MAYENI CASTILLA DNP, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date: 06/09/2020
Reactivation Date: 06/22/2022

III. Provider practice location address

776 NW 2ND ST
MIAMI FL
33128-1454
US

IV. Provider business mailing address

776 NW 2ND ST
MIAMI FL
33128-1454
US

V. Phone/Fax

Practice location:
  • Phone: 321-207-6470
  • Fax:
Mailing address:
  • Phone: 321-207-6470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11005805
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: