Healthcare Provider Details

I. General information

NPI: 1104353663
Provider Name (Legal Business Name): YAMILA AUTIE CASTRO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2017
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16025 SW 103RD LN
MIAMI FL
33196-6181
US

IV. Provider business mailing address

16025 SW 103RD LN
MIAMI FL
33196-6181
US

V. Phone/Fax

Practice location:
  • Phone: 786-626-4067
  • Fax:
Mailing address:
  • Phone: 786-626-4067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025085756
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-50666
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11018970
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: