Individual provider Active NPI

Raquel Leilani Santos, ARNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooksville, FL
National Provider Identifier
1184405060
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11029042 Issued in FL
Practice address
16332 Cortez Blvd Ste F
Brooksville, FL 34601-8980
Phone
(813) 999-1516
NPI assigned
Oct 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11029042 FL Primary

Addresses

Primary practice location

16332 Cortez Blvd Ste F
Brooksville, FL 34601-8980

Mailing address

13600 Weatherstone Dr
Spring Hill, FL 34609-2060
Phone (787) 602-4792

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
I20231121002115 FL Practitioner - Nurse Practitioner 3274981832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Learning to Achieve Wellness IncGroup PAC ID 9234514464, 48 clinicians

Practice addresses (Care Compare)

413 W Robertson St
Suite B
Brandon, FL 33511-5014
Phone (813) 999-1516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11029042FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Learning to Achieve Wellness Inc Psychiatric/Mental Health CurrentSince Nov 1, 2023 Accepting new patients

Locations

413 W Robertson St
Ste B
Brandon, FL 33511
Phone (813) 657-4711

16332 Cortez Blvd
Ste F
Brooksville, FL 34601

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1184405060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13600 WEATHERSTONE DR",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346092060",
            "telephone_number": "787-602-4792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16332 CORTEZ BLVD STE F",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346018980",
            "telephone_number": "813-999-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "RAQUEL",
        "middle_name": "LEILANI",
        "credential": "ARNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11029042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

Verify at the official NPI Registry.