Individual provider Active NPI

Mary Jane Alcantara Venzon, ARNP

  • Nurse Practitioner
  • Winter Park, FL
National Provider Identifier
1821489204
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9404408 Issued in FL
Practice address
2304 Aloma Ave Ste 100
Winter Park, FL 32792-3330
Phone
(407) 679-9222
Fax
(407) 679-9061
NPI assigned
Feb 6, 2015
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9404408 FL Primary
Nurse Practitioner 363L00000X H119413 IA

Addresses

Primary practice location

2304 Aloma Ave Ste 100
Winter Park, FL 32792-3330

Mailing address

2304 Aloma Ave Ste 100
Winter Park, FL 32792-3330
Phone (407) 679-9222

Other practice location 1

115 8th St NE
Cedar Rapids, IA 52401-1013
Phone (319) 363-3565

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
I20151130001078 FL Practitioner - Nurse Practitioner 4789901992

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Primary Care Network Inc CurrentSince Aug 1, 2023 Accepting new patients
Metcare of Florida, Inc Past Accepting new patients
Southwest Volusia Healthcare Corporation Past Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

1070 N Stone St
Ste A
Deland, FL 32720
Phone (386) 943-7100

Interoperability endpoints

  • Direct secure messaging: mvenzon71022@adventhealth.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1821489204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 ALOMA AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923330",
            "telephone_number": "407-679-9222",
            "fax_number": "407-679-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 ALOMA AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923330",
            "telephone_number": "407-679-9222",
            "fax_number": "407-679-9061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 8th St NE",
            "address_purpose": "LOCATION",
            "city": "Cedar Rapids",
            "state": "IA",
            "postal_code": "524011013",
            "country_code": "US",
            "telephone_number": "319-363-3565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENZON",
        "first_name": "MARY JANE",
        "middle_name": "ALCANTARA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-06",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9404408",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "H119413",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.