Ailissa Tekla Retalic, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

11040778 Issued in FL

Practice address

110 Pond CT Ste 201
Debary, FL 32713-2717

Phone

(386) 317-8635

NPI assigned

Jul 9, 2025

Last updated

Dec 9, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Florida Health Care Plan, Inc

  dba Florida Health Care Plans Inc.

  • Preferred Provider Organization
  • Daytona Beach, FL
  • NPI 1558302042
  Medicare reassignment NPD
• Florida Health Care Plan, Inc

  dba FHCP ASC - Orange City

  • Ambulatory Surgical Clinic/Center
  • Orange City, FL
  • NPI 1659759827
  NPD

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1417847492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 WHIPPOORWILL LN",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202103",
            "telephone_number": "386-490-7537",
            "fax_number": "386-490-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 POND CT STE 201",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132717",
            "telephone_number": "386-317-8635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETALIC",
        "first_name": "AILISSA",
        "middle_name": "TEKLA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11040778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Ramirez
• Ria Amoy Ramnarine
• Ramon Hernandez
• Marna Rasmussen, AP
• Respiratory Kinect Inc (Care Options HomeHealth Services)
• Caitlyn Rhoades, APRN
• Richard C. Montz DDS, PA (River City Dentistry)
• River City Chiropractic and Injury
• Melvin Daniel Rivera Carrero, MD
• Iliana Rivera

• Psychiatric/Mental Health Nurse Practitioner in Debary, FL
• Providers in Debary, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.