MEDICARE: MR. JOHN R JONES JR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH 9187	FL

General Provider Information

NPI Number	:	1093884793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN R JONES JR.

Provider Business Mailing Address
First Line	:	228 SOUTHPARK CIR E
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32086-5135
Country	:	US
Telephone Number	:	904-797-5680
Fax Number	:	904-797-5681

Provider Business Practice Location Address
First Line	:	228 SOUTHPARK CIR E
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32086-5135
Country	:	US
Telephone Number	:	904-797-5680
Fax Number	:	904-797-5681

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	05/06/2026

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