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NPI Code Detail

MEDICARE: MS. KAITLIN CASTILLO

MEDICARE: MS. KAITLIN CASTILLO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSA 12022FL

General Provider Information

NPI Number : 1437576899
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAITLIN CASTILLO
Provider Business Mailing Address
First Line : 5140 GATE PKWY APT 3304
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-0234
Country : US
Telephone Number : 904-716-6113
Fax Number :
Provider Business Practice Location Address
First Line : 11512 LAKE MEAD AVE UNIT 604
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-9686
Country : US
Telephone Number : 904-716-6113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2014
Last Update Date : 03/24/2014

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Directions to “ MS. KAITLIN CASTILLO ” Practice Location

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