Healthcare Provider Details
I. General information
NPI: 1457262537
Provider Name (Legal Business Name): LEVEL MIND
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13111 ROYAL PINES AVE
RIVERVIEW FL
33579-9323
US
IV. Provider business mailing address
13111 ROYAL PINES AVE
RIVERVIEW FL
33579-9323
US
V. Phone/Fax
- Phone: 656-218-5690
- Fax: 656-400-5764
- Phone: 656-218-5690
- Fax: 656-400-5764
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAINA
NORRIS
Title or Position: OWNER
Credential: PMHNP
Phone: 656-218-5690