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General NPI Number Information
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NPI Number | 1972258218
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Entity Type | Organization
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Legal Business Name | VITAL MINDS PSYCHIATRY, LLC
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 863 BIG BUCK CIRCLE
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City | WINTER SPRINGS
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State | FL
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Zip | 32708
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Country | US
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Telephone | 407-221-3678
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Fax |
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Provider Business Mailing Address
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Address Line | 863 BIG BUCK CIR
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-5127
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Country | US
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Telephone | 407-221-3678
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Fax |
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER
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Name | MS. TELIYA ZYAMBO
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Credential | APRN
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Telephone | 407-221-3678
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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 |
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License Number State |
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