Provider Demographics
NPI:1063407062
Name:JONES, D. ALLEN (RPT)
Entity type:Individual
Prefix:MR
First Name:D.
Middle Name:ALLEN
Last Name:JONES
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6813
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33758-6813
Mailing Address - Country:US
Mailing Address - Phone:727-571-3222
Mailing Address - Fax:727-573-0332
Practice Address - Street 1:6170 ULMERTON RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3950
Practice Address - Country:US
Practice Address - Phone:727-571-3222
Practice Address - Fax:727-573-0332
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5624225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106571Medicare ID - Type Unspecified