Provider Demographics
NPI:1902449606
Name:JAIME, HECTOR (FNP-C)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:JAIME
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 WINTER SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER SPGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-3801
Mailing Address - Country:US
Mailing Address - Phone:321-439-7775
Mailing Address - Fax:
Practice Address - Street 1:1304 WINTER SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER SPGS
Practice Address - State:FL
Practice Address - Zip Code:32708-3801
Practice Address - Country:US
Practice Address - Phone:321-439-7775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004780363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily