Individual provider Active NPI

Jannelle Mendiola Bautista, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1033927157
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11034875 Issued in FL
Practice address
515 S Kings Ave Ste 3100
Brandon, FL 33511-5921
Phone
(813) 681-9171
Fax
(877) 409-2423
NPI assigned
Dec 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11034875 FL
Family Nurse Practitioner 363LF0000X APRN11034875 FL Primary

Addresses

Primary practice location

515 S Kings Ave Ste 3100
Brandon, FL 33511-5921

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0033

Other practice location 1

2452 4th Street North
St. Petersburg, FL 33704
Phone (727) 308-5020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250110000680 FL Practitioner - Nurse Practitioner 3678001294 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care Florida LLCGroup PAC ID 9234031444, 324 clinicians

Practice addresses (Care Compare)

515 S Kings Ave
Suite 3100
Brandon, FL 33511-5921
Phone (813) 681-9171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11034875FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Womens' Health Hospitalists, LLC CurrentSince Mar 5, 2025 Accepting new patients
Ivx Health of Florida, P.a. CurrentSince Dec 13, 2024 Accepting new patients
Women's Care Florida LLC Nurse Practitioner CurrentSince Mar 5, 2025 Accepting new patients
Infusion Express of Kansas LLC Past Accepting new patients

Locations

293 E Altamonte Dr
Ste 1201
Altamonte Springs, FL 32701
Phone (407) 392-3171

515 S Kings Ave
Brandon, FL 33511
Phone (813) 681-9171

515 S Kings Ave
Ste 3100
Brandon, FL 33511
Phone (813) 681-9171

13123 Kings Lake Dr
Unit 102
Gibsonton, FL 33534
Phone (813) 574-1350

5470 Lithia Pinecrest Rd
Lithia, FL 33547
Phone (813) 675-9181

2108 Thonotosassa Rd
Plant City, FL 33563
Phone (813) 752-4103

6606 Simmons Loop
Ste 200
Riverview, FL 33578

6606 Simmons Loop
Riverview, FL 33578
Phone (813) 574-1350

5002 W Lemon St
Tampa, FL 33609

10007 N Dale Mabry Hwy
Tampa, FL 33618
Phone (813) 331-0513

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

Interoperability endpoints

  • Direct secure messaging: jannelle.bautista@wcfnf.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1033927157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S KINGS AVE STE 3100",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115921",
            "telephone_number": "813-681-9171",
            "fax_number": "877-409-2423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2452 4th Street North",
            "address_purpose": "LOCATION",
            "city": "St. Petersburg",
            "state": "FL",
            "postal_code": "33704",
            "country_code": "US",
            "telephone_number": "727-308-5020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "JANNELLE",
        "middle_name": "MENDIOLA",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-20",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11034875",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11034875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.