MEDICARE: OSAMU 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
1	133V00000X	Registered Dietitian	ND15191	FL

General Provider Information

NPI Number	:	1871427682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSAMU JONES

Provider Business Mailing Address
First Line	:	523 NW 23RD AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-7723
Country	:	US
Telephone Number	:	907-250-6316
Fax Number	:

Provider Business Practice Location Address
First Line	:	523 NW 23RD AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-7723
Country	:	US
Telephone Number	:	907-250-6316
Fax Number	:

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

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “ OSAMU JONES ” Practice Location

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