Healthcare Provider Details

I. General information

NPI: 1932618485
Provider Name (Legal Business Name): JAIME MAURER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2017
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4205 BELFORT RD STE 1100
JACKSONVILLE FL
32216-5876
US

IV. Provider business mailing address

4205 BELFORT RD STE 4015
JACKSONVILLE FL
32216-3623
US

V. Phone/Fax

Practice location:
  • Phone: 904-296-3103
  • Fax:
Mailing address:
  • Phone:
  • Fax: 904-450-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9183846
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: