Provider Demographics
NPI:1225581697
Name:JONES, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:JONES
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 1:5401 S KIRKMAN RD
Mailing Address - Street 2:SUITE 324
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7940
Mailing Address - Country:US
Mailing Address - Phone:407-536-4444
Mailing Address - Fax:844-791-6090
Practice Address - Street 1:5401 S KIRKMAN RD
Practice Address - Street 2:SUITE 324
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7940
Practice Address - Country:US
Practice Address - Phone:407-536-4444
Practice Address - Fax:844-791-6090
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health