Healthcare Provider Details

I. General information

NPI: 1679482707
Provider Name (Legal Business Name): JAM SPECAILIZED HEALTHCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 STATE ROAD 419 STE 270
WINTER SPRINGS FL
32708-2672
US

IV. Provider business mailing address

3625 STATE ROAD 419 STE 270
WINTER SPRINGS FL
32708-2672
US

V. Phone/Fax

Practice location:
  • Phone: 407-604-5077
  • Fax:
Mailing address:
  • Phone: 407-604-5077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: JUANITA MARTIN
Title or Position: CEO
Credential:
Phone: 407-453-8671