Provider Demographics
NPI:1497340392
Name:CALDWELL, KAYLA NOEL
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:NOEL
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9785 MIA CIR UNIT 5208
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8875
Mailing Address - Country:US
Mailing Address - Phone:407-450-1959
Mailing Address - Fax:
Practice Address - Street 1:9785 MIA CIR UNIT 5208
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8875
Practice Address - Country:US
Practice Address - Phone:407-450-1959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator