Healthcare Provider Details

I. General information

NPI: 1164330403
Provider Name (Legal Business Name): KVON JONES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7441 114TH AVE STE 604
LARGO FL
33773-5124
US

IV. Provider business mailing address

6906 CASTLEGATE DR APT D
TAMPA FL
33617-8944
US

V. Phone/Fax

Practice location:
  • Phone: 727-492-5369
  • Fax: 727-544-5900
Mailing address:
  • Phone: 716-520-8632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: