Provider Demographics
NPI:1437396470
Name:JONES, KEITH ARMANDO
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:ARMANDO
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:KEITH
Other - Middle Name:ARMANDO
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OCCUPATIONAL THERAPI
Mailing Address - Street 1:127 PINE VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-2302
Mailing Address - Country:US
Mailing Address - Phone:386-668-7679
Mailing Address - Fax:
Practice Address - Street 1:127 PINE VALLEY COURT
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713
Practice Address - Country:US
Practice Address - Phone:386-668-7679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0001793225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist