MEDICARE: DR. NINA T JORDANIA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	036107234	IL
2	2084P0800X	Psychiatry Physician	ME126750	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00924097	OTHER		MEDICARE RAILROAD (PROVIDER)
6	CA4748	OTHER		MEDICARE RAILROAD (GROUP)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	036107234	OTHER	IL	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1033149844	OTHER	IL	CDPG NPI
5	0222075	OTHER	IL	BLUE CROSS GROUP
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164428074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NINA T JORDANIA MD

Provider Business Mailing Address
First Line	:	25111 PENNYROYAL DR
Second Line	:	STE 1
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7944
Country	:	US
Telephone Number	:	630-740-8375
Fax Number	:	630-740-8375

Provider Business Practice Location Address
First Line	:	6801 PORTO FINO CIR
Second Line	:	STE 1
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4344
Country	:	US
Telephone Number	:	239-225-0874
Fax Number	:	239-225-1465

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	03/20/2017

Similar Medicare Providers

1396419610 — DNA COMPREHENSIVE THERAPY SERVICES, LLC
Practice Location Address:

6801 PORTO FINO CIR STE 1
FORT MYERS, FL
33912-4344

Practice Phone: 239-223-2751
Practice Fax: 239-561-2933

1437521218 — DR. STEPHEN BAILEY M.D.
Practice Location Address:

21471 WIDGEON TER
FORT MYERS BEACH, FL
33931-4344

Practice Phone: 239-314-5633
Practice Fax:

1821149733 — FORT WORTH REHAB GROUP
Practice Location Address:

3301 N MAIN ST , SUITE B
FORT WORTH, TX
76106-4344

Practice Phone: 817-624-4141
Practice Fax: 817-624-4227

1336518711 — LAKESHIA QUENIC BURR
Practice Location Address:

2825 STONEWAY LN APT B
FORT PIERCE, FL
34982-4344

Practice Phone: 772-878-9000
Practice Fax: 772-878-9600

1497754105 — THOMAS J ZEKAN MD
Practice Location Address:

13813 METRO PKWY
FORT MYERS, FL
33912-4343

Practice Phone: 855-674-4624
Practice Fax: 941-883-8386

1669311635 — CLAUDIA BELTRAN
Practice Location Address:

14121 CAMBRIDGE DR APT 104
FORT MYERS, FL
33912-2073

Practice Phone: 941-208-2910
Practice Fax:

Directions to “ DR. NINA T JORDANIA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.