Healthcare Provider Details

I. General information

NPI: 1558780197
Provider Name (Legal Business Name): JORDAN BRITTNI MILNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD # HD-204
GAINESVILLE FL
32610-1524
US

IV. Provider business mailing address

1600 SW ARCHER RD # HD-204
GAINESVILLE FL
32610-1600
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-9120
  • Fax:
Mailing address:
  • Phone: 352-273-9120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberME154765
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: