Provider Demographics
NPI:1255087326
Name:JAMIE, DANIEL ALDEN (SRNA)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALDEN
Last Name:JAMIE
Suffix:
Gender:M
Credentials:SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 N ORANGE AVE APT 4409
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1385
Mailing Address - Country:US
Mailing Address - Phone:386-292-6543
Mailing Address - Fax:
Practice Address - Street 1:650 N ORANGE AVE APT 4409
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1385
Practice Address - Country:US
Practice Address - Phone:386-292-6543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-26
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9487115163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse