Provider Demographics
NPI:1639344955
Name:JONES, GLENDA KAY (OTR)
Entity Type:Individual
Prefix:MS
First Name:GLENDA
Middle Name:KAY
Last Name:JONES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2922 SW 92ND LANE RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-7411
Mailing Address - Country:US
Mailing Address - Phone:352-854-2504
Mailing Address - Fax:
Practice Address - Street 1:2922 SW 92ND LANE RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-7411
Practice Address - Country:US
Practice Address - Phone:352-854-2504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890628900Medicaid