Healthcare Provider Details

I. General information

NPI: 1497190110
Provider Name (Legal Business Name): JAMES A JORDAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 NE 53RD ST
FT LAUDERDALE FL
33308-3212
US

IV. Provider business mailing address

2340 NE 53RD ST
FT LAUDERDALE FL
33308-3212
US

V. Phone/Fax

Practice location:
  • Phone: 954-491-7835
  • Fax:
Mailing address:
  • Phone: 954-491-7835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME10078
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: