Healthcare Provider Details

I. General information

NPI: 1073097085
Provider Name (Legal Business Name): JAI CHAPMAN MA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12724 GRAN BAY PKWY W STE 410
JACKSONVILLE FL
32258-9486
US

IV. Provider business mailing address

2035 SW 75TH ST
GAINESVILLE FL
32607-3425
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone: 352-332-8588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90558
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: