Edenfield, Jonathan

Edenfield, Jonathan is an individual health care provider with primary practice located at 12276 San Jose Blvd Ste. 508, Jacksonville FL 32223-8628. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is his primary health care specialty. Edenfield, Jonathan can be contacted via phone (904) 886-3228.

Contact Information

Primary practice address
12276 San Jose Blvd Ste. 508 Jacksonville FL 32223-8628
Phone: (904) 886-3228
Fax: (904) 886-3297
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT9495 Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT 9495 Florida

Profile Details

NPI number 1598781932
LBN Legal business name Edenfield, Jonathan
Credentials M.S. OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 15th, 2006
Last updated May 14th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598781932 NPPES
Florida MEDICAID 885813000
Florida Other Y909B

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