Provider Demographics
NPI:1942821509
Name:JONES, ROBERT LANARD
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LANARD
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3047 MIKRIS DR E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-7607
Mailing Address - Country:US
Mailing Address - Phone:772-267-2317
Mailing Address - Fax:904-619-6065
Practice Address - Street 1:3047 MIKRIS DR E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-7607
Practice Address - Country:US
Practice Address - Phone:772-267-2317
Practice Address - Fax:904-619-6065
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106205000Medicaid