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General NPI Number Information
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NPI Number | 1497649453
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Entity Type | Individual
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Provider Name | EYLEEN CANNON APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 4300 S HWY 27 STE 205E
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City | CLERMONT
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State | FL
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Zip | 34711-8067
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Country | US
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Telephone | 407-974-6539
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 203
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City | MINNEOLA
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State | FL
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Zip | 34755-0203
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Country | US
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Telephone |
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11039012
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License Number State | FL
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