Individual provider Active NPI

Gerslene Datis

  • Psychiatric/Mental Health Nurse Practitioner
  • Auburndale, FL
National Provider Identifier
1659258648
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11041324 Issued in FL
Practice address
391 Havendale Blvd
Auburndale, FL 33823-4536
Phone
(561) 667-4166
NPI assigned
Aug 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 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 APRN11041324 FL Primary

Addresses

Primary practice location

391 Havendale Blvd
Auburndale, FL 33823-4536

Mailing address

391 Havendale Blvd
Auburndale, FL 33823-4536
Phone (561) 667-4166

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2345 Sand Lake Rd
Suite 200
Orlando, FL 32809-9120

8007 Horse Ferry Rd
Orlando, FL 32835-5977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11041324FLMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1659258648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 HAVENDALE BLVD",
            "city": "AUBURNDALE",
            "state": "FL",
            "postal_code": "338234536",
            "telephone_number": "561-667-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 HAVENDALE BLVD",
            "city": "AUBURNDALE",
            "state": "FL",
            "postal_code": "338234536",
            "telephone_number": "561-667-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATIS",
        "first_name": "GERSLENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11041324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburndale, FL

Sources for this page

Verify at the official NPI Registry.