Individual provider Active NPI

Sukaina Nicophene, MSN, ARNP-C, PMHNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1265782064
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
07250075 Issued in FL
Practice address
1044 E Brandon Blvd
Brandon, FL 33511-5509
Phone
(321) 732-5617
NPI assigned
Sep 19, 2012
Last updated
Aug 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9267886 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 07250075 FL Primary

Addresses

Primary practice location

1044 E Brandon Blvd
Brandon, FL 33511-5509

Mailing address

525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone (321) 732-5617

Other identifiers 2

IdentifierTypeStateIssuer
008157200MedicaidFL
P01120210OtherFLR&R MEDICARE

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
I20121211000176 FL Practitioner - Nurse Practitioner 4789836156 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Luisa Vega DNP LLCGroup PAC ID 3577872605, 83 clinicians

Practice addresses (Care Compare)

1044 E Brandon Blvd
Suite 1And2
Brandon, FL 33511-5509
Phone (813) 403-4423

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9267886FLMDFamily Nurse Practitioner
07250075FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Rehab Specialists, PLLC CurrentSince Aug 5, 2025 Accepting new patients
Dr Luisa Vega DNP LLC Psychiatric/Mental Health CurrentSince Apr 18, 2022 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Nov 15, 2012 Accepting new patients
Florida Medical Clinic LLC CurrentSince Nov 15, 2012 Accepting new patients
The Restorative Clinic, LLC Current Accepting new patients

Locations

1044 E Brandon Blvd
Ste 12
Brandon, FL 33511
Phone (813) 403-4423

817 NW 56th Ter
Ste B
Gainesville, FL 32605
Phone (352) 331-7771

525 Technology Park
Lake Mary, FL 32746
Phone (407) 347-4331

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

2800 SW 41st St
Ocala, FL 34474
Phone (352) 291-4600

100 S Ashley Dr
Ste 6002324
Tampa, FL 33602
Phone (203) 747-8696

300 NW 1st Ave
Williston, FL 32696
Phone (352) 528-3561

38021 Market Square Dr
Zephyrhills, FL 33542
Phone (813) 715-0374

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

Organizations & group practices 5

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": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1265782064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 TECHNOLOGY PARK STE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467107",
            "telephone_number": "321-732-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 E BRANDON BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115509",
            "telephone_number": "321-732-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOPHENE",
        "first_name": "SUKAINA",
        "name_prefix": "Ms.",
        "credential": "MSN, ARNP-C, PMHNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9267886",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "07250075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008157200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R&R MEDICARE",
            "identifier": "P01120210",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.