Provider Demographics
NPI:1285918169
Name:MCGUIRE, JAZMIN Y (CNA)
Entity type:Individual
Prefix:
First Name:JAZMIN
Middle Name:Y
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1074 E HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-6424
Mailing Address - Country:US
Mailing Address - Phone:407-545-1822
Mailing Address - Fax:
Practice Address - Street 1:125 BASIN ST
Practice Address - Street 2:SUITE 110
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-5078
Practice Address - Country:US
Practice Address - Phone:386-252-9282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL218277376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004029700Medicaid