Healthcare Provider Details

I. General information

NPI: 1427862473
Provider Name (Legal Business Name): JONATHAN LOFTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2025
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28410 BONITA XING BLVD UNIT 150
BONITA SPRINGS FL
34135-3217
US

IV. Provider business mailing address

19991 BARLETTA LN UNIT 1924
ESTERO FL
33928-6400
US

V. Phone/Fax

Practice location:
  • Phone: 239-451-7163
  • Fax:
Mailing address:
  • Phone: 813-944-0423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-25-16434
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number23-254750
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: