Healthcare Provider Details

I. General information

NPI: 1710473517
Provider Name (Legal Business Name): LARHONDA MARIE ENSLOW APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 05/20/2025
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 EAST MAGNOLIA AVE
EUSTIS FL
32726-1904
US

IV. Provider business mailing address

PO BOX 491000
LEESBURG FL
34749-1000
US

V. Phone/Fax

Practice location:
  • Phone: 352-357-1550
  • Fax: 352-357-1103
Mailing address:
  • Phone: 352-315-7800
  • Fax: 352-314-8858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9256994
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9256994
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: