Provider Demographics
NPI:1407272651
Name:JAMES, PRIYA
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3993 W STATE ROAD 46
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9726
Mailing Address - Country:US
Mailing Address - Phone:407-732-4272
Mailing Address - Fax:
Practice Address - Street 1:3993 W STATE ROAD 46
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9726
Practice Address - Country:US
Practice Address - Phone:407-732-4272
Practice Address - Fax:407-732-4579
Is Sole Proprietor?:No
Enumeration Date:2014-03-12
Last Update Date:2024-05-07
Deactivation Date:2021-01-18
Deactivation Code:
Reactivation Date:2021-02-24
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011226101YM0800X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health