Healthcare Provider Details

I. General information

NPI: 1043101033
Provider Name (Legal Business Name): JAMES CADE SPARKS SRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

455 DWELL WAY APT 121
OVIEDO FL
32765-8372
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-5600
  • Fax:
Mailing address:
  • Phone: 903-905-2886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number9632274
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: