Healthcare Provider Details

I. General information

NPI: 1265386320
Provider Name (Legal Business Name): REBEKAH M SIRECI APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 US 1 S
ST AUGUSTINE FL
32086-6077
US

IV. Provider business mailing address

6901A N 9TH AVE # 402
PENSACOLA FL
32504-6638
US

V. Phone/Fax

Practice location:
  • Phone: 813-999-1516
  • Fax: 813-441-8519
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11045660
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: