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General NPI Number Information
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NPI Number | 1023444361
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Entity Type | Individual
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Provider Name | JAY J RHODES L.O.F.
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Gender | Male
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 12/16/2013
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Provider Practice Location Address
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Address Line | 621 CAPE CORAL PKWY E SUITE 1
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City | CAPE CORAL
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State | FL
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Zip | 33904-7515
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Country | US
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Telephone | 239-541-9480
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Fax | 888-537-3611
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Provider Business Mailing Address
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Address Line | 4706 CHIQUITA BLVD S # 200 PMB 408
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City | CAPE CORAL
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State | FL
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Zip | 33914-6321
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Country | US
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Telephone | 239-541-9480
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Fax | 888-537-3611
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225000000X
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Taxonomy Name | Orthotic Fitter
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License Number | ORF119
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License Number State | FL
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