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General NPI Number Information
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NPI Number | 1518675156
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Entity Type | Individual
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Provider Name | MARA-JOANNE DERINOR DNP, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | PO BOX 423356
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City | KISSIMMEE
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State | FL
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Zip | 34742-3356
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Country | US
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Telephone | 347-460-9989
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Fax | 407-337-0137
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Provider Business Mailing Address
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Address Line | PO BOX 423356
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City | KISSIMMEE
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State | FL
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Zip | 34742-3356
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Country | US
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Telephone | 347-460-9989
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Fax | 407-337-0137
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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 | 11023083
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License Number State | FL
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