Provider Demographics
NPI:1134332067
Name:JONES, JEFFREY ALAN (CSFA)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:ALAN
Last Name:JONES
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23110 STATE ROAD 54
Mailing Address - Street 2:# 157
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-6933
Mailing Address - Country:US
Mailing Address - Phone:813-929-0174
Mailing Address - Fax:813-235-9409
Practice Address - Street 1:22427 SOUTHSHORE DR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-4639
Practice Address - Country:US
Practice Address - Phone:813-929-0174
Practice Address - Fax:813-235-9409
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL82586246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65-0912916OtherFED. TAX ID NUMBER