Healthcare Provider Details

I. General information

NPI: 1346117488
Provider Name (Legal Business Name): JORDYN PITTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 CYPRESS RD
PLANTATION FL
33317-2382
US

IV. Provider business mailing address

5001 SW 201ST TER
SW RANCHES FL
33332-1011
US

V. Phone/Fax

Practice location:
  • Phone: 954-399-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: