Provider Demographics
NPI:1437049129
Name:JAKES, CARLA L
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:L
Last Name:JAKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 SW 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:CHIEFLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32626-0401
Mailing Address - Country:US
Mailing Address - Phone:850-321-6506
Mailing Address - Fax:
Practice Address - Street 1:501 SW 2ND AVE
Practice Address - Street 2:
Practice Address - City:CHIEFLAND
Practice Address - State:FL
Practice Address - Zip Code:32626-0401
Practice Address - Country:US
Practice Address - Phone:850-321-6506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant