MEDICARE: ANGELA JONES RRT

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	227800000X	Certified Respiratory Therapist	T12667	FL
2	227900000X	Registered Respiratory Therapist	RT 9736	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497903793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA JONES RRT

Provider Business Mailing Address
First Line	:	PO BOX 141241
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32614-1241
Country	:	US
Telephone Number	:	352-381-8381
Fax Number	:

Provider Business Practice Location Address
First Line	:	1505 FORT CLARKE BLVD APT 11108
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-9120
Country	:	US
Telephone Number	:	352-381-8381
Fax Number	:

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

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	03/16/2011

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