Healthcare Provider Details

I. General information

NPI: 1285643056
Provider Name (Legal Business Name): JIMA L. JONES TE AL PTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SONOTECH IMAGING

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 12/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 FRIST BLVD SUITE 2
FORT PIERCE FL
34950-4839
US

IV. Provider business mailing address

1611 ORANGE AVE
FORT PIERCE FL
34950-6816
US

V. Phone/Fax

Practice location:
  • Phone: 772-465-1500
  • Fax: 772-465-0050
Mailing address:
  • Phone: 772-465-1500
  • Fax: 772-465-0050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number14477
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number14477
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: