Healthcare Provider Details

I. General information

NPI: 1043157365
Provider Name (Legal Business Name): GLIMMER OF HOPE WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14530 SCOTTBURGH GLEN DR
WIMAUMA FL
33598-6177
US

IV. Provider business mailing address

14530 SCOTTBURGH GLEN DR
WIMAUMA FL
33598-6177
US

V. Phone/Fax

Practice location:
  • Phone: 813-649-5191
  • Fax:
Mailing address:
  • Phone:
  • 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: SAINTANISE SAINTILUS
Title or Position: OWNER
Credential:
Phone: 813-649-5191