Healthcare Provider Details

I. General information

NPI: 1558298190
Provider Name (Legal Business Name): JALEN RASHAWN BARNETT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JAYDE BARNETT

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2486 LAKE DEBRA DR APT 5101
ORLANDO FL
32835-8718
US

IV. Provider business mailing address

2486 LAKE DEBRA DR APT 5101
ORLANDO FL
32835-8718
US

V. Phone/Fax

Practice location:
  • Phone: 407-307-4616
  • Fax:
Mailing address:
  • Phone: 407-307-4616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: