Provider Demographics
NPI:1689312951
Name:JONES, CAROLINE MICHELLE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:MICHELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3403
Mailing Address - Country:US
Mailing Address - Phone:321-632-0081
Mailing Address - Fax:
Practice Address - Street 1:2316 S FISKE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3403
Practice Address - Country:US
Practice Address - Phone:321-632-0081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT41496225100000X
NCP21553225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist