Healthcare Provider Details

I. General information

NPI: 1134077829
Provider Name (Legal Business Name): GOLDEN MIND PSYCHIATRIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 N DONNELLY ST STE 11
MOUNT DORA FL
32757-4835
US

IV. Provider business mailing address

1136 MERION DR
MOUNT DORA FL
32757-8724
US

V. Phone/Fax

Practice location:
  • Phone: 352-436-8326
  • Fax:
Mailing address:
  • Phone: 352-436-8326
  • Fax:

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: MIRANDA JO BRYANT
Title or Position: APRN, PMHNP-C, OWNER
Credential: APRN
Phone: 207-249-9121