Provider Demographics
NPI:1285431668
Name:CASTILLO, MIKAYLA (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7907 HEATHER CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-2236
Mailing Address - Country:US
Mailing Address - Phone:813-734-1524
Mailing Address - Fax:
Practice Address - Street 1:4125 GUNN HWY STE B1
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-8788
Practice Address - Country:US
Practice Address - Phone:813-778-5682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13353235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist