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General NPI Number Information
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NPI Number | 1184218695
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Entity Type | Individual
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Provider Name | DR. CRAIG JORDEN JR.
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Gender | Male
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 412 E MADISON ST STE 1012
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City | TAMPA
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State | FL
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Zip | 33602-4618
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Country | US
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Telephone | 813-364-4465
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Fax | 813-359-1886
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Provider Business Mailing Address
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Address Line | 455 N US HIGHWAY 41 UNIT 1126
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City | RUSKIN
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State | FL
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Zip | 33575-5246
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Country | US
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Telephone | 813-364-4465
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Fax | 813-359-1886
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 11011653
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | 11011653
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 11011653
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11011653
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 11011653
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 364SP0812X
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Taxonomy Name | Community Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 11011653
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11011653
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License Number State | FL
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