Healthcare Provider Details

I. General information

NPI: 1346189719
Provider Name (Legal Business Name): SAINTANISE C SAINTILUS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1046 E BRANDON BLVD
BRANDON FL
33511-5509
US

IV. Provider business mailing address

14530 SCOTTBURGH GLEN DR
WIMAUMA FL
33598-6177
US

V. Phone/Fax

Practice location:
  • Phone: 813-785-0182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11046290
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: