Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | ME0078870 | FL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME0078870 | FL |
NPI | 1619051075 |
---|---|
Provider Name | Dr. Kathy Y Jones |
First Address | Celebration, FL 34747-0308 |
Second Address | Orlando, FL 32804-4642 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 08/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
259275400 | (05) | FL |
BJ4581321 | DEA (01) | FL |
G18311 | (02) | FL |
ME0078870 | MEDICAL LICENSE (01) | FL |