MEDICARE: JILL BAJUS STOKES

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	225100000X	Physical Therapist	PT10783	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	:	1902946213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL BAJUS STOKES

Provider Business Mailing Address
First Line	:	3667 JULINGTON CREEK ROAD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-3714
Country	:	US
Telephone Number	:	904-591-0799
Fax Number	:	904-683-4266

Provider Business Practice Location Address
First Line	:	3667 JULINGTON CREEK RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-3714
Country	:	US
Telephone Number	:	904-591-0799
Fax Number	:	904-683-4266

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/05/2017

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