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NPI Code Detail

MEDICARE: JAIMIE GOSIKER BCBA

MEDICARE:   JAIMIE  GOSIKER  BCBA
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
1103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21639320203OTHERCORPORATE NPI TYPE 2
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144749953
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAIMIE GOSIKER BCBA
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 866-610-0580
Fax Number :
Provider Business Practice Location Address
First Line : 124 CAPULET DR STE 102
Second Line :
City : SAINT AUGUSTINE
State : FL
Zip : 32092-4538
Country : US
Telephone Number : 904-602-9745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2017
Last Update Date : 08/18/2022

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Directions to “ JAIMIE GOSIKER BCBA” Practice Location

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