Provider Demographics
NPI:1649634296
Name:JONES, KEITH LEE (APRN)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:LEE
Last Name:JONES
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 NE SPANISH RIVER BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4500
Mailing Address - Country:US
Mailing Address - Phone:561-347-1112
Mailing Address - Fax:561-368-0459
Practice Address - Street 1:500 NE SPANISH RIVER BLVD STE 102
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4500
Practice Address - Country:US
Practice Address - Phone:561-347-1112
Practice Address - Fax:561-368-0459
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9195868363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health