Roberson, Jordan

Roberson, Jordan is an sole proprietor health care provider with primary practice located at 1737 N Clyde Morris Blvd Ste 300 , Daytona Beach FL 32117-5533. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Roberson, Jordan can be contacted via phone (386) 262-1627.

Contact Information

Primary practice address
1737 N Clyde Morris Blvd Ste 300 Daytona Beach FL 32117-5533
Phone: (386) 262-1627
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN9410928 Florida

Profile Details

NPI number 1669965000
LBN Legal business name Roberson, Jordan
Credentials PMHNP-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 11th, 2018
Last updated Jun 17th, 2026 - about 4 months 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 1669965000 NPPES
Florida MEDICAID 100175900

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