Organization
MINDHEARTBODY COMPREHENSIVE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEJUANNA CORSON NP (APRN)
(813) 317-3930
Entity
Organization
Contact information
Practice address
13148 VAIL RIDGE DR, RIVERVIEW, FL 33579-7187
(813) 317-3930
Mailing address
13148 VAIL RIDGE DR, RIVERVIEW, FL 33579-7187
(813) 317-3930
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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