Basic Information
| Provider Information | |||||||||
| NPI: | 1952721904 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | ABRILL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5870 HIATUS RD | ||||||||
| Address2: | REGIONAL ADMIN OFFICE PE-WEST | ||||||||
| City: | TAMARAC | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333216424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8884472362 | ||||||||
| FaxNumber: | 8655607110 | ||||||||
| Practice Location | |||||||||
| Address1: | 821 N NELLIS BLVD | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891105339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024384003 | ||||||||
| FaxNumber: | 7024380555 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2014 | ||||||||
| LastUpdateDate: | 11/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 18096 | NV | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 18096 | 01 | NV | STATE LICENSE | OTHER | 1952721904 | 05 | NV | MEDICAID |