Provider Demographics
NPI:1851500847
Name:JONES, ANGELA N (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:N
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6405 N FEDERAL HWY
Mailing Address - Street 2:STE 401
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-1421
Mailing Address - Country:US
Mailing Address - Phone:561-939-0462
Mailing Address - Fax:561-939-5460
Practice Address - Street 1:1601 CLINT MOORE RD
Practice Address - Street 2:SUITE 145
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2768
Practice Address - Country:US
Practice Address - Phone:561-939-0462
Practice Address - Fax:561-939-5460
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME995942086S0102X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279757700Medicaid
FLAG278ZMedicare PIN