Basic Information
Provider Information
NPI: 1952570863
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: CLAUDE
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: D.O
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10300 SW 216TH ST
Address2:  
City: CUTLER BAY
State: FL
PostalCode: 331901003
CountryCode: US
TelephoneNumber: 3055991015
FaxNumber: 7863365000
Practice Location
Address1: 10300 SW 216TH ST
Address2:  
City: CUTLER BAY
State: FL
PostalCode: 331901003
CountryCode: US
TelephoneNumber: 3052535100
FaxNumber: 3052525881
Other Information
ProviderEnumerationDate: 02/25/2008
LastUpdateDate: 03/29/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XOS10007FLY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
OS1000701FLLICENSEOTHER


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