Individual provider Active NPI

Eyleen Cannon, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Minneola, FL
National Provider Identifier
1497649453
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11039012 Issued in FL
Practice address
600 S Main Ave Unit 100
Minneola, FL 34715-9578
Phone
(352) 703-6341
NPI assigned
Jun 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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 APRN11039012 FL Primary

Addresses

Primary practice location

600 S Main Ave Unit 100
Minneola, FL 34715-9578

Mailing address

PO Box 203
Minneola, FL 34755-0203

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
I20250709004430 FL Practitioner - Nurse Practitioner 2466966544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Still Waters Psychiatry PLLCGroup PAC ID 1052823200, 3 clinicians

Practice addresses (Care Compare)

300 N Ronald Reagan Blvd
Suite 204
Longwood, FL 32750-4162
Phone (407) 974-6539

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Still Waters Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jul 1, 2025 Accepting new patients
Collaborative Psychiatric Care & Wellness LLC Psychiatric/Mental Health PastSince Jun 8, 2025 Accepting new patients
Tele Med Clinix LLC PastSince Jun 1, 2025 Accepting new patients
Tele Med Clinix Lousiana PastSince Jun 1, 2025 Accepting new patients

Locations

1070 Montgomery Rd
Altamonte Springs, FL 32714
Phone (407) 504-7121

4300 S Highway 27
Ste 205E
Clermont, FL 34711
Phone (407) 974-6539

300 N Ronald Reagan Blvd
Ste 204
Longwood, FL 32750
Phone (407) 974-6539

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1497649453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 203",
            "city": "MINNEOLA",
            "state": "FL",
            "postal_code": "347550203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S MAIN AVE UNIT 100",
            "city": "MINNEOLA",
            "state": "FL",
            "postal_code": "347159578",
            "telephone_number": "352-703-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "EYLEEN",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-04",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11039012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneola, FL

Sources for this page

Verify at the official NPI Registry.