Individual provider Active NPI

Matthew Thomas Lebron, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange City, FL
National Provider Identifier
1801641469
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11032005 Issued in FL
Practice address
2060 Sherwood Forest Dr
Orange City, FL 32763-6355
Phone
(407) 212-7424
Fax
(386) 310-0586
NPI assigned
Apr 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 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 11032005 FL Primary

Addresses

Primary practice location

2060 Sherwood Forest Dr
Orange City, FL 32763-6355

Mailing address

2060 Sherwood Forest Dr
Orange City, FL 32763-6355
Phone (407) 453-3506

Other practice location 1

2637 W State Road 426 Ste 1021
Oviedo, FL 32765-8325
Phone (321) 340-3490

Other practice location 2

13571 Narcoossee Rd
Orlando, FL 32832-7136
Phone (321) 340-3490

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
I20250429002075 FL Practitioner - Nurse Practitioner 0143746552 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11032005FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Clarity Psychiatric Solutions, PLLC Psychiatric/Mental Health CurrentSince Mar 30, 2025 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Mar 25, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

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": "1713398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1801641469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 SHERWOOD FOREST DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327636355",
            "telephone_number": "407-453-3506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 SHERWOOD FOREST DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327636355",
            "telephone_number": "407-212-7424",
            "fax_number": "386-310-0586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2637 W State Road 426 Ste 1021",
            "address_purpose": "LOCATION",
            "city": "Oviedo",
            "state": "FL",
            "postal_code": "327658325",
            "country_code": "US",
            "telephone_number": "321-340-3490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13571 Narcoossee Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328327136",
            "country_code": "US",
            "telephone_number": "321-340-3490",
            "fax_number": "321-340-4755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBRON",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-18",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11032005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.