Jordan, Walter Jerome

Jordan, Walter Jerome is an sole proprietor health care provider with primary practice located at 600 40Th St N Apt 111 , St Petersburg FL 33713-6339. He recently has only one registered license in Agencies / Home Health, which is considered as his primary health care specialty. Jordan, Walter Jerome can be contacted via phone (727) 657-8392.

Contact Information

Primary practice address
600 40Th St N Apt 111 St Petersburg FL 33713-6339
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X 235565 Florida

Profile Details

NPI number 1447733712
LBN Legal business name Jordan, Walter Jerome
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 12th, 2018
Last updated Sep 12th, 2018 - about 8 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 1447733712 NPPES
Florida Other 235565 AGENCY FOR HEALTH CARE ADMINISTRATION

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