Provider Demographics
NPI:1841789997
Name:JAIME MEDICAL, INC.
Entity Type:Organization
Organization Name:JAIME MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:HASELEU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-685-1376
Mailing Address - Street 1:11350 66TH ST STE 116
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-5525
Mailing Address - Country:US
Mailing Address - Phone:360-281-3900
Mailing Address - Fax:
Practice Address - Street 1:11350 66TH ST STE 116
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-5525
Practice Address - Country:US
Practice Address - Phone:727-685-1369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-04
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies