Individual provider Active NPI

Taymi Milagros Rival Castillo, APRN, MSN, BSN, RN

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1801465885
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11013827 Issued in FL
Practice address
5172 Mason Corbin CT Ste 1
Fort Myers, FL 33907-4540
Phone
(239) 936-7171
Fax
(239) 936-6084
NPI assigned
Jun 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11013827 FL Primary

Addresses

Primary practice location

5172 Mason Corbin CT Ste 1
Fort Myers, FL 33907-4540

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other practice location 1

13882 SW 162nd Ter
Miami, FL 33177-1953
Phone (561) 502-9670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220419001850 FL Practitioner - Nurse Practitioner 0840687927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carmona Medical Care IncGroup PAC ID 4486076080, 8 clinicians

Practice addresses (Care Compare)

2307 Bolado Pkwy
Cape Coral, FL 33990-2712
Phone (239) 424-8122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
11013827FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carmona Medical Care Inc CurrentSince Aug 1, 2022 Accepting new patients
B&H Health Services Inc Family CurrentSince Apr 1, 2022 Accepting new patients
Brainhealth MD LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

1708 Cape Coral Pkwy W
Ste 4
Cape Coral, FL 33914
Phone (239) 945-5940

428 Del Prado Blvd N
Ste 103
Cape Coral, FL 33909
Phone (239) 351-2044

2307 Bolado Pkwy
Cape Coral, FL 33990
Phone (239) 424-8122

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1801465885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5172 MASON CORBIN CT STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074540",
            "telephone_number": "239-936-7171",
            "fax_number": "239-936-6084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13882 SW 162nd Ter",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331771953",
            "country_code": "US",
            "telephone_number": "561-502-9670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVAL CASTILLO",
        "first_name": "TAYMI",
        "middle_name": "MILAGROS",
        "credential": "APRN, MSN, BSN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11013827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.