Individual provider Active NPI

Ivette Medrano, APRN, PMHNP-BC, DNP

  • Psychiatric/Mental Health Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1639678899
Registry record updated Sep 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11004085 Issued in FL
Practice address
7901 4TH St N # 23125
St Petersburg, FL 33702-4305
Phone
(786) 592-0331
NPI assigned
Feb 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2025

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 11004085 FL Primary

Addresses

Primary practice location

7901 4TH St N # 23125
St Petersburg, FL 33702-4305

Mailing address

7901 4TH St N Ste 23125
St Petersburg, FL 33702-4305
Phone (727) 210-5589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2025 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11004085FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
True North Integrative Psychiatry PLLC CurrentSince May 4, 2025 Accepting new patients
Ultima Rehab-FL LLC CurrentSince Dec 25, 2021 Accepting new patients
Better Beginnings LLC Psychiatric/Mental Health PastSince Dec 6, 2020 Accepting new patients

Locations

390 Pondella Rd
Ste 9
North Ft Myers, FL 33903
Phone (239) 652-0260

Organizations & group practices 3

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": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757116800000",
    "number": "1639678899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 23125",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024305",
            "telephone_number": "727-210-5589",
            "fax_number": "833-605-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N # 23125",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024305",
            "telephone_number": "786-592-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO",
        "first_name": "IVETTE",
        "name_prefix": "Dr.",
        "credential": "APRN, PMHNP-BC, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2025-09-06",
        "certification_date": "2025-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11004085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.