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General NPI Number Information
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NPI Number | 1043876378
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Entity Type | Individual
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Provider Name | R. DAVID JONES RN, OPERATIONS MGR.
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Gender | Male
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Dates
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Enumeration Date | 05/13/2019
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Last Update Date | 05/13/2019
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Provider Practice Location Address
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Address Line | 2020 E OAKLAND PARK BLVD STE B
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1106
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Country | US
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Telephone | 754-779-1830
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 SE 3RD AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2877
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Country | US
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Telephone | 954-815-4967
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Fax | 754-200-5155
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MH12874
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License Number State | FL
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