1225183114 NPI number — UNITED CEREBRAL PALSY OF N FLORIDA

Table of content: MRS. JAIME LEIGH BAKER MA (NPI 1518326081)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225183114 NPI number — UNITED CEREBRAL PALSY OF N FLORIDA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED CEREBRAL PALSY OF N FLORIDA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225183114
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1241 N EAST AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PANAMA CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32401-4426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-769-7960
Provider Business Mailing Address Fax Number:
850-769-1060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1241 N EAST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PANAMA CITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32401-4426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-769-7960
Provider Business Practice Location Address Fax Number:
850-769-1060
Provider Enumeration Date:
01/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCMANUS
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
EXEC DIRECTOR
Authorized Official Telephone Number:
850-769-7960

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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