Provider Demographics
NPI:1053439356
Name:JONES, AMANDA L
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5745 SW 75TH ST
Mailing Address - Street 2:PMB #231
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-5504
Mailing Address - Country:US
Mailing Address - Phone:352-281-3262
Mailing Address - Fax:352-377-7364
Practice Address - Street 1:4909 NW 27TH CT
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6590
Practice Address - Country:US
Practice Address - Phone:352-377-6008
Practice Address - Fax:352-377-7364
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA49509225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist