Provider Demographics
NPI:1891420832
Name:JONES, SHERITA CHARAE
Entity Type:Individual
Prefix:
First Name:SHERITA
Middle Name:CHARAE
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 1:13500 LAKE VINING DR APT 16103
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-6213
Mailing Address - Country:US
Mailing Address - Phone:213-425-9975
Mailing Address - Fax:
Practice Address - Street 1:13500 LAKE VINING DR APT 16103
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-6213
Practice Address - Country:US
Practice Address - Phone:213-425-9975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter