Provider Demographics
NPI:1497903793
Name:JONES, ANGELA (RRT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 141241
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32614-1241
Mailing Address - Country:US
Mailing Address - Phone:352-381-8381
Mailing Address - Fax:
Practice Address - Street 1:1505 FORT CLARKE BLVD APT 11108
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-9120
Practice Address - Country:US
Practice Address - Phone:352-381-8381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-29
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLT12667227800000X
FLRT 9736227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL693416196Medicaid
FL693416197Medicaid