Milcah Grace S Caculitan, FNP

Key facts

NPI

1306279807

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

ARNP3193432 (FL)

Practice address

1120 Carlton Ave
Suite 1300
Lake Wales, FL 33853-4348

Phone

(863) 676-6386

Fax

(863) 676-6452

NPI assigned

Aug 20, 2013

Sex

Female

Sole proprietor

No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• KSC Cardiology PA Specialist · Winter Haven, FL · NPI 1023035862
  Medicare reassignment NPD FL
• Midflorida Internal Medicine Associates, PA Internal Medicine Physician · Winter Haven, FL · NPI 1275702037
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BEJADA
• Direct secure messaging: milcah.caculitan@kscc.eclinicaldirectplus.com

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 20, 2013.

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1306279807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 CARLTON AVE",
            "address_2": "SUITE 1300",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534348",
            "telephone_number": "863-676-6386",
            "fax_number": "863-676-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 CARLTON AVE",
            "address_2": "SUITE 1300",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534348",
            "telephone_number": "863-676-6386",
            "fax_number": "863-676-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACULITAN",
        "first_name": "MILCAH GRACE",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3193432",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3193432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Lake Wales, FL · Family Nurse Practitioner in Florida