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General NPI Number Information
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NPI Number | 1013566165
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Entity Type | Individual
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Provider Name | JORDAN LEE HUFFMAN PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 3250 ZEMKE AVE 6TH MEDICAL GROUP
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City | MACDILL AFB
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State | FL
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Zip | 33621-5023
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Country | US
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Telephone | 813-827-9390
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Fax |
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Provider Business Mailing Address
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Address Line | 133 41ST AVE NE
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City | SAINT PETERSBURG
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State | FL
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Zip | 33703-5823
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Country | US
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Telephone | 712-899-2313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | PT33820
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License Number State | FL
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