Healthcare Provider Details

I. General information

NPI: 1871385195
Provider Name (Legal Business Name): JONATHAN JARAMILLO APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 N SEMORAN BLVD STE 102
WINTER PARK FL
32792-3800
US

IV. Provider business mailing address

483 N SEMORAN BLVD STE 102
WINTER PARK FL
32792-3800
US

V. Phone/Fax

Practice location:
  • Phone: 407-645-1847
  • Fax: 321-274-0322
Mailing address:
  • Phone: 407-645-1847
  • Fax: 321-274-0322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11039655
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: