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General NPI Number Information
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NPI Number | 1124417142
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Entity Type | Individual
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Provider Name | VICTORIA JACOBY FNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/14/2015
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1599 TROPICAL CT STE 8
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City | TAVARES
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State | FL
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Zip | 32778-4323
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Country | US
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Telephone | 352-316-7205
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Fax | 870-408-4059
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Provider Business Mailing Address
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Address Line | 239 AUGUST FERN LOOP
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City | MOUNT DORA
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State | FL
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Zip | 32757-2806
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Country | US
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Telephone | 870-278-7359
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Fax | 870-408-4059
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A004275
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11011098
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11011098
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License Number State | FL
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