Healthcare Provider Details

I. General information

NPI: 1104799022
Provider Name (Legal Business Name): SHANAYA CAJUSTE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 SW 23RD TER
GAINESVILLE FL
32608-2956
US

IV. Provider business mailing address

2910 MAGUIRE RD STE 2002
OCOEE FL
34761-4742
US

V. Phone/Fax

Practice location:
  • Phone: 754-234-2747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11042599
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: