Provider Demographics
NPI:1316571284
Name:CASTILLA, CHEILA MAYENI (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHEILA
Middle Name:MAYENI
Last Name:CASTILLA
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 S ORANGE BLOSSOM TRI
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-1454
Mailing Address - Country:US
Mailing Address - Phone:407-428-5751
Mailing Address - Fax:
Practice Address - Street 1:232 S ORANGE BLOSSOM TRI
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-1454
Practice Address - Country:US
Practice Address - Phone:407-428-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-28
Last Update Date:2022-07-20
Deactivation Date:2020-06-09
Deactivation Code:
Reactivation Date:2022-06-22
Provider Licenses
StateLicense IDTaxonomies
FL11005805363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily