MEDICARE: KERA ANN JONES OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC6847	FL
2	152WC0802X	Corneal and Contact Management Optometrist	10397687-9934	UT
3	152W00000X	Optometrist	10397687-9934	UT
4	152W00000X	Optometrist	011104	NY

General Provider Information

NPI Number	:	1154843423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERA ANN JONES OD

Provider Business Mailing Address
First Line	:	3408 S FLORIDA AVE
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33803-4765
Country	:	US
Telephone Number	:	863-646-4437
Fax Number	:

Provider Business Practice Location Address
First Line	:	3408 S FLORIDA AVE
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33803-4765
Country	:	US
Telephone Number	:	863-646-4437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2017
Last Update Date	:	04/21/2026

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