Healthcare Provider Details

I. General information

NPI: 1053030015
Provider Name (Legal Business Name): JAMIE DUANE GUY MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 S ORANGE AVE FL 3
ORLANDO FL
32801-3394
US

IV. Provider business mailing address

450 S ORANGE AVE FL 3
ORLANDO FL
32801-3394
US

V. Phone/Fax

Practice location:
  • Phone: 407-686-6888
  • Fax: 407-610-6872
Mailing address:
  • Phone: 407-686-6888
  • Fax: 407-610-6872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11022656
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9398628
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number309763
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: