Provider Demographics
NPI:1972258218
Name:VITAL MINDS PSYCHIATRY, LLC
Entity Type:Organization
Organization Name:VITAL MINDS PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:TELIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZYAMBO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:407-221-3678
Mailing Address - Street 1:863 BIG BUCK CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5127
Mailing Address - Country:US
Mailing Address - Phone:407-221-3678
Mailing Address - Fax:
Practice Address - Street 1:863 BIG BUCK CIRCLE
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708
Practice Address - Country:US
Practice Address - Phone:407-221-3678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty