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NPI Code Detail

MEDICARE: MRS. JILL JONES MHS CCC-SLP

MEDICARE: MRS. JILL JONES MHS CCC-SLP
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
1235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
109932114OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1689893851
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JILL JONES MHS CCC-SLP
Provider Business Mailing Address
First Line : 2701 N ROCKY POINT DR
Second Line : SUITE 650
City : TAMPA
State : FL
Zip : 33607-5917
Country : US
Telephone Number : 800-892-0640
Fax Number : 888-213-3018
Provider Business Practice Location Address
First Line : 2701 N ROCKY POINT DR
Second Line : SUITE 650
City : TAMPA
State : FL
Zip : 33607-5917
Country : US
Telephone Number : 800-892-0640
Fax Number : 888-213-3018
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2007
Last Update Date : 09/02/2016

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