Jonathan L Detlefs, EXEMPT APP.

Primary specialty

Chore ProviderTaxonomy code 372500000X

License

DL190541 Issued in SD

Practice address

13876 Atlantic Blvd
Jacksonville, FL 32225-3239

Phone

(904) 620-0000

Fax

(904) 274-0111

NPI assigned

Mar 24, 2026

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1774310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1649118175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13876 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253239",
            "telephone_number": "904-620-0000",
            "fax_number": "904-274-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13876 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253239",
            "telephone_number": "904-620-0000",
            "fax_number": "904-274-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETLEFS",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "EXEMPT APP.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "SD",
            "license": "DL190541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Don Bernard Destephano, MD
• Erica Davalt Destephano, OT
• Patricia Ann Destephano, OTR
• Roseline A Desvaristes, M.D.
• Kevin John Determan, B.S.,D.C.,F.A.S.A.
• Nicole Pauline Detrick
• Catherine Dettelbach Lake, FNP-C
• William Naragon Deuring, DMD
• Eric Christopher Deussing, MD
• Amie G Deutch, MD

• Chore Provider in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Chore Provider in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.