Provider Demographics
NPI:1659858694
Name:JONES, MARILYN ELAINE
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:ELAINE
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 1:7480 ALOMA AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9102
Mailing Address - Country:US
Mailing Address - Phone:321-274-7737
Mailing Address - Fax:321-244-0253
Practice Address - Street 1:7480 ALOMA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9102
Practice Address - Country:US
Practice Address - Phone:407-988-3048
Practice Address - Fax:321-244-0253
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator