Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

San Thawalanthanne

Individual provider Mental Health Counselor · NPI 1275397622

San Thawalanthanne is a Nurse Practitioner in Longwood, Florida. Qualified in 2023, 3 years ago. Practices with Tampa Neuropsychiatry, a 15-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
3
Licensed in
FL
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

2290 N Ronald Reagan Blvd Ste 116
Longwood, FL 32750-3534
Phone: (407) 215-0095
Fax: (407) 261-0523
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 106 W Windhorst Rd, Brandon, FL 33510-2455 — (813) 373-9531

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 11031100 (FL)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1275397622
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 7, 2024
Last updated in NPPESNovember 4, 2024
Certification dateNovember 4, 2024
Mailing address1000 S Lake Dr, Clearwater, FL 33756-4415

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Tampa Neuropsychiatry — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Longwood