Healthcare Provider Details

I. General information

NPI: 1902772445
Provider Name (Legal Business Name): DAYANA BARBARA SANTOS CHAVEZ APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6360 PRESIDENTIAL CT STE 1
FORT MYERS FL
33919-3501
US

IV. Provider business mailing address

6360 PRESIDENTIAL CT STE 1
FORT MYERS FL
33919-3501
US

V. Phone/Fax

Practice location:
  • Phone: 786-373-3027
  • Fax: 786-802-2011
Mailing address:
  • Phone: 786-373-3027
  • Fax: 786-802-2011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11042909
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: