Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | OS11855 | FL |
NPI | 1063649937 |
---|---|
Provider Name | Dr. Lily N Jones |
First Address | Safety Harbor, FL 34695-6605 |
Second Address | Safety Harbor, FL 34695-6605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2009 |
Last Update Date | 30/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
012058500 | (05) | FL |