Jordan, Eric A

Jordan, Eric A is an individual health care provider with primary practice located at 1350 Hickory St Suite 102, Melbourne FL 32901-3224. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Jordan, Eric A can be contacted via phone (321) 434-3455.

Contact Information

Primary practice address
1350 Hickory St Suite 102 Melbourne FL 32901-3224
Phone: (321) 434-3455
Fax: (321) 434-3456
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9107646 Florida

Profile Details

NPI number 1649609793
LBN Legal business name Jordan, Eric A
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2013
Last updated Apr 9th, 2019 - about 7 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 1649609793 NPPES
Florida MEDICAID 010029600
Florida Other HP736Y

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