Healthcare Provider Details

I. General information

NPI: 1164356713
Provider Name (Legal Business Name): ALICIA JONES PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11300 NE 2ND AVE
MIAMI SHORES FL
33161-6695
US

IV. Provider business mailing address

11300 NE 2ND AVE
MIAMI SHORES FL
33161-6695
US

V. Phone/Fax

Practice location:
  • Phone: 305-899-3130
  • Fax:
Mailing address:
  • Phone: 305-899-3130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number03587
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: