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NPI Code Detail

MEDICARE: BROOKE JONES

MEDICARE: BROOKE JONES
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
1224Z00000XOccupational Therapy Assistant13379FL

General Provider Information

NPI Number : 1639570948
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE JONES
Provider Business Mailing Address
First Line : 6601 CAMDEN BAY DR APT 301
Second Line :
City : TAMPA
State : FL
Zip : 33635-9062
Country : US
Telephone Number : 727-485-5634
Fax Number :
Provider Business Practice Location Address
First Line : 2600 HIGHLANDS BLVD N
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-2114
Country : US
Telephone Number : 727-785-5671
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2014
Last Update Date : 09/17/2014

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