MEDICARE: JASMINE LYNETTE TEJADA PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11047635	FL

General Provider Information

NPI Number	:	1588593115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE LYNETTE TEJADA PMHNP

Provider Business Mailing Address
First Line	:	2500 CIVITAS PL
Second Line	:
City	:	CASSELBERRY
State	:	FL
Zip	:	32707-2415
Country	:	US
Telephone Number	:	347-452-6217
Fax Number	:

Provider Business Practice Location Address
First Line	:	587 E STATE ROAD 434 UNIT 1025
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-5284
Country	:	US
Telephone Number	:	347-452-6217
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/21/2026

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