Provider Demographics
NPI:1598848491
Name:JONES, DEBORAH ANN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANN
Last Name:JONES
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SE 19TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2840
Mailing Address - Country:US
Mailing Address - Phone:954-662-3668
Mailing Address - Fax:954-779-7445
Practice Address - Street 1:300 SE 19TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-2840
Practice Address - Country:US
Practice Address - Phone:954-662-3668
Practice Address - Fax:954-779-7445
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2886213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU83282Medicare UPIN
FL65691Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER