Healthcare Provider Details

I. General information

NPI: 1003521006
Provider Name (Legal Business Name): SOLREI BEHAVIORAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 06/11/2023
Certification Date: 06/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 CONROY WINDERMERE RD STE 200
WINDERMERE FL
34786-8431
US

IV. Provider business mailing address

9100 CONROY WINDERMERE RD STE 200
WINDERMERE FL
34786-8431
US

V. Phone/Fax

Practice location:
  • Phone: 407-638-8903
  • 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: JODENE JENSEN
Title or Position: PRESIDENT
Credential:
Phone: 407-638-8903