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NPI Code Detail

MEDICARE: JORDAN L LOFTIS MD

MEDICARE:   JORDAN L LOFTIS  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
1207Q00000XFamily Medicine Physician48796CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11477711760OTHERCONPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477711760
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN L LOFTIS MD
Provider Business Mailing Address
First Line : 1980 N ATLANTIC AVE STE 905
Second Line :
City : COCOA BEACH
State : FL
Zip : 32931-3277
Country : US
Telephone Number : 321-342-4948
Fax Number : 321-342-7451
Provider Business Practice Location Address
First Line : 1980 N ATLANTIC AVE STE 905
Second Line :
City : COCOA BEACH
State : FL
Zip : 32931-3277
Country : US
Telephone Number : 321-342-4948
Fax Number : 321-342-7451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2008
Last Update Date : 02/28/2025

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