MEDICARE: JACINTA F FELDMAN CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	ARNP1053372	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124284161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACINTA F FELDMAN CNM

Provider Business Mailing Address
First Line	:	850 W PLYMOUTH AVE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-3284
Country	:	US
Telephone Number	:	386-736-6110
Fax Number	:	386-736-7998

Provider Business Practice Location Address
First Line	:	850 W PLYMOUTH AVE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-3284
Country	:	US
Telephone Number	:	386-736-6110
Fax Number	:	386-736-7998

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	12/26/2012

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