Healthcare Provider Details

I. General information

NPI: 1669383485
Provider Name (Legal Business Name): MAISON CLARTE PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1148 STANTON SHADOW LN
APOPKA FL
32712-5485
US

IV. Provider business mailing address

1148 STANTON SHADOW LN
APOPKA FL
32712-5485
US

V. Phone/Fax

Practice location:
  • Phone: 407-494-7168
  • Fax:
Mailing address:
  • Phone: 407-720-6463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL CLYDE PALAFOX
Title or Position: APRN
Credential: APRN, PMHNP-BC
Phone: 407-720-6463