Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 4871 | FL |
NPI | 1932403474 |
---|---|
Provider Name | Dr. Jordan Howard Jordan |
First Address | Coral Springs, FL 33076-3300 |
Second Address | Coral Springs, FL 33076-3300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/12/2010 |
Last Update Date | 27/12/2010 |