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NPI Code Detail

MEDICARE: PAIGE JORDAN MEDLEY APRN

MEDICARE: PAIGE JORDAN MEDLEY APRN
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
1363LA2100XAcute Care Nurse Practitioner11004065FL
2363LA2100XAcute Care Nurse PractitionerAPRN11004065FL
3363L00000XNurse PractitionerAPRN11004065FL

Other Identifiers

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

General Provider Information

NPI Number : 1528696523
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAIGE JORDAN MEDLEY APRN
Provider Business Mailing Address
First Line : 2900 CORPORATE WAY
Second Line : DOOR D
City : MIRAMAR
State : FL
Zip : 33025-3925
Country : US
Telephone Number : 954-276-5685
Fax Number : 954-985-7074
Provider Business Practice Location Address
First Line : 1150 N 35TH AVE STE 300
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-5428
Country : US
Telephone Number : 954-265-1490
Fax Number : 954-989-0454
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2020
Last Update Date : 05/15/2026

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