MEDICARE: SUSAN MARIE JORDAN FNP-BC

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	363L00000X	Nurse Practitioner	APRN11043730	FL

General Provider Information

NPI Number	:	1649131335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MARIE JORDAN FNP-BC

Provider Business Mailing Address
First Line	:	8976 CONROY WINDERMERE ROAD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835
Country	:	US
Telephone Number	:	407-217-2410
Fax Number	:	407-723-7555

Provider Business Practice Location Address
First Line	:	8976 CONROY WINDERMERE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-3128
Country	:	US
Telephone Number	:	321-848-4986
Fax Number	:

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

Provider Enumeration Date	:	11/21/2025
Last Update Date	:	02/04/2026

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