MEDICARE: JORDAN JONES

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	103K00000X	Behavior Analyst		FL

Other Identifiers

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

General Provider Information

NPI Number	:	1508313214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN JONES

Provider Business Mailing Address
First Line	:	2761 OCEAN CLUB BLVD APT 204
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-3926
Country	:	US
Telephone Number	:	561-601-2749
Fax Number	:

Provider Business Practice Location Address
First Line	:	2761 OCEAN CLUB BLVD APT 204
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-3926
Country	:	US
Telephone Number	:	561-601-2749
Fax Number	:

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

Provider Enumeration Date	:	09/10/2016
Last Update Date	:	08/30/2025

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