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General NPI Number Information
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NPI Number | 1053298125
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Entity Type | Individual
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Provider Name | JAMIE MARANDO HIS
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Gender | Female
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1680 DUNLAWTON AVE
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City | PORT ORANGE
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State | FL
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Zip | 32127-4754
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Country | US
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Telephone | 386-756-8225
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Fax | 386-767-0742
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Provider Business Mailing Address
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Address Line | 3840 S NOVA RD STE B1
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City | PORT ORANGE
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State | FL
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Zip | 32127-4244
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Country | US
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Telephone | 386-756-8225
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Fax | 386-767-0742
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS5906
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License Number State | FL
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