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NPI Code Detail

MEDICARE: MICHAEL JONES DPT ATC CSCS LLC

MEDICARE: MICHAEL JONES DPT ATC CSCS LLC
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1831884402
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHAEL JONES DPT ATC CSCS LLC
Provider Business Mailing Address
First Line : 4914 BALLASTONE DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257-3000
Country : US
Telephone Number : 954-240-8632
Fax Number :
Provider Business Practice Location Address
First Line : 8210 CYPRESS PLAZA DR STE 101
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-4475
Country : US
Telephone Number : 904-516-0124
Fax Number :
Authorized Official
Title or Position : OWNER, PHYSICAL THERAPIST
Name : MICHAEL RYAN JONES
Credential : PT, DPT, OCS, CSCS
Telephone Number : 954-240-8632
Provider Enumeration Date : 04/10/2023
Last Update Date : 02/26/2025

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