Shirley Casillas

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9308118 Issued in FL

Practice address

1102 A1A N
Unit 104
Ponte Vedra Beach, FL 32082-4098

Phone

(904) 273-6533

Fax

(904) 273-6532

NPI assigned

Sep 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1952779290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 HAWTHORN HEDGE LN",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594804",
            "telephone_number": "904-392-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 A1A N",
            "address_2": "UNIT 104",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824098",
            "telephone_number": "904-273-6533",
            "fax_number": "904-273-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASILLAS",
        "first_name": "SHIRLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9308118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor M Cardenas, M.D.
• Jeanette Carlsen
• Mackenzie Carr
• Levan Angella Carter, APRN11039417
• Michael Edward Carver, H.A.S.
• Claire Castellano, LPC
• Clayton Christopher Celander, DMD
• Stephanie Michelle Ceparano
• Adam I. Chaifetz, D.C.
• Charles Perniciaro MD PA (Neptune Beach Dermatology)

• Family Nurse Practitioner in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.