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General NPI Number Information
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NPI Number | 1407267693
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Entity Type | Individual
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Provider Name | SHEA JONES D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2014
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 900 PINE ST STE 111B
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City | ENGLEWOOD
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State | FL
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Zip | 34223-4457
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Country | US
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Telephone | 941-786-0790
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Fax | 941-786-0959
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Provider Business Mailing Address
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Address Line | 900 PINE ST
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City | ENGLEWOOD
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State | FL
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Zip | 34223-4418
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Country | US
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Telephone | 941-786-0790
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Fax | 941-786-0959
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | OS16726
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License Number State | FL
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