Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MT202233 | PA |
Y | 207VX0201X | Gynecologic Oncologist | ME132146 | FL |
NPI | 1487916649 |
---|---|
Provider Name | Dr. Scott E Jordan |
First Address | Fort Lauderdale, FL 33309-3750 |
Second Address | Fort Lauderdale, FL 33316-2510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2012 |
Last Update Date | 12/11/2020 |