MEDICARE: DUVAL MENTAL HEALTH AND WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1477482644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUVAL MENTAL HEALTH AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	3275 S JOHN YOUNG PKWY STE 904
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-6556
Country	:	US
Telephone Number	:	407-988-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	3857 BOWFIN TRL
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-1956
Country	:	US
Telephone Number	:	407-988-1500
Fax Number	:

Authorized Official
Title or Position	:	PMHNP/FNP
Name	:	VALENCIA DULCIO
Credential	:	APRN
Telephone Number	:	407-988-1500

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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