Provider Demographics
NPI:1992402515
Name:MILFORD, CAYLA (PA-C)
Entity type:Individual
Prefix:
First Name:CAYLA
Middle Name:
Last Name:MILFORD
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-868-7272
Mailing Address - Fax:
Practice Address - Street 1:5821 S WILLIAMSON BLVD STE 204
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32128-6102
Practice Address - Country:US
Practice Address - Phone:386-231-6300
Practice Address - Fax:386-322-6165
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9116985363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRR206OtherMEDICARE HF
FLPENDINGMedicaid