Healthcare Provider Details

I. General information

NPI: 1518895713
Provider Name (Legal Business Name): GLADIOLUS SERENITY MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 SE 47TH ST STE C2
CAPE CORAL FL
33904-9661
US

IV. Provider business mailing address

1222 SE 47TH ST STE C2
CAPE CORAL FL
33904-9661
US

V. Phone/Fax

Practice location:
  • Phone: 239-397-4099
  • Fax: 239-946-0296
Mailing address:
  • Phone: 239-397-4099
  • Fax: 239-946-0296

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: ELJESS CLERVIL
Title or Position: OWNER
Credential: NP
Phone: 239-895-2317