Healthcare Provider Details

I. General information

NPI: 1386077733
Provider Name (Legal Business Name): OLENA ZHUKOVA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2013
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7916 EVOLUTIONS WAY STE 102
TRINITY FL
34655-9900
US

IV. Provider business mailing address

7916 EVOLUTIONS WAY STE 102
TRINITY FL
34655-9900
US

V. Phone/Fax

Practice location:
  • Phone: 727-910-5990
  • Fax: 727-910-5992
Mailing address:
  • Phone: 727-910-5990
  • Fax: 727-910-5992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9243501
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: