Healthcare Provider Details

I. General information

NPI: 1437490190
Provider Name (Legal Business Name): NATASHA VERNON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2013
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 LIMIT AVE STE 207 SUITE 207
MOUNT DORA FL
32757-3135
US

IV. Provider business mailing address

1303 LIMIT AVE STE 207 SUITE 207
MOUNT DORA FL
32757-3135
US

V. Phone/Fax

Practice location:
  • Phone: 352-405-0078
  • Fax: 808-300-5938
Mailing address:
  • Phone: 407-694-7286
  • Fax: 808-300-5938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN9305774
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9305774
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberAPRN9305774
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: