Jordan, Jacob
Jordan, Jacob is an individual health care provider with primary practice located at 2335 Tamiami Trail N. Suite 501, Naples FL 34103-4456. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Jordan, Jacob can be contacted via phone (239) 263-0011.Contact Information
Primary practice address
2335 Tamiami Trail N. Suite 501
Naples FL 34103-4456
Phone: (239) 263-0011
Fax: (239) 430-7823
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | ME0047319 | Florida |
Profile Details
| NPI number | 1417048554 |
|---|---|
| LBN Legal business name | Jordan, Jacob |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 27th, 2006 |
| Last updated | Apr 6th, 2017 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417048554 | NPPES |
| Florida | Other | P00877422 | RR MEDICARE |
| Florida | Other | P305081 | RR MEDICARE |
| Florida | Other | 08461 | RR MEDICARE |
| Florida | Other | 201912 | RR MEDICARE |
| Florida | Other | 5954082 | RR MEDICARE |
| Florida | MEDICAID | 057907600 | RR MEDICARE |
| Florida | Other | 292168 | RR MEDICARE |
| Florida | Other | QMP000005106623 | RR MEDICARE |
| Florida | Other | P953733 | RR MEDICARE |
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