Provider Demographics
NPI:1538278395
Name:JAMESON, PAULA L (ARNP)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:L
Last Name:JAMESON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E PRINCETON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1456
Mailing Address - Country:US
Mailing Address - Phone:407-896-2901
Mailing Address - Fax:407-896-2902
Practice Address - Street 1:615 E PRINCETON ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1456
Practice Address - Country:US
Practice Address - Phone:407-896-2901
Practice Address - Fax:407-896-2902
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2609002363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL302408300Medicaid
E4809ZMedicare PIN
P17682Medicare UPIN