Adebola Kafayat Adegbenro, APRN
Individual provider Active NPI Registered Nurse · Lake Mary, FL
NPI 1154970796 · NPPES record last updated Feb 7, 2026
Key facts
- NPI
- 1154970796
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 1051648 (TX)
- Practice address
- 205 Morning Glory Dr
Lake Mary, FL 32746-3304 - Phone
- (214) 281-9302
- NPI assigned
- Sep 6, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
82 Wendell Ave
Suite 100
Pittsfield, MA 01201-7066
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1051648 | TX | MD | Registered Nurse |
| 349695 | TX | MD | Licensed Vocational Nurse |
| APRN11044371 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
| RN2360005 | MA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serenity Minds Health PLLC | Psychiatric/Mental Health | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1051648 | TX | Yes |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN2360005 | MA | |
| Licensed Vocational Nurse | 164X00000X | 349695 | TX | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN11044371 | FL |
Addresses
Primary practice location
205 Morning Glory Dr
Lake Mary, FL 32746-3304
Mailing address
205 Morning Glory Dr
Lake Mary, FL 32746-3304
Phone (214) 281-9302
Other providers in Lake Mary, FL
- Leslie Diane Acreman
- Acuphysio360, LLC
- Digmory Lizzie Adair
- Angela Denise Adams
- Reginald Ade
- Ogechukwu Adekweh
- Monica Adhav
- Advanced Endodontics of Lake Mary
- Advanced Healthcare Staffing Solutions, LLC
- Advanced Heart and Vascular Medicine, Inc.
All providers in Lake Mary, FL · Registered Nurse in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 7, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.