Healthcare Provider Details

I. General information

NPI: 1952296253
Provider Name (Legal Business Name): KYLEE VICTORIA CASTRO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS KYLEE VICTORIA WHEELOCK

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 S TAMIAMI TRL
SARASOTA FL
34239-4504
US

IV. Provider business mailing address

3209 38TH AVE E
BRADENTON FL
34208-7230
US

V. Phone/Fax

Practice location:
  • Phone: 941-925-2020
  • Fax:
Mailing address:
  • Phone: 207-299-5165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number03250550
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: