MEDICARE: MR. JORDAN HAMMERMAN

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	101Y00000X	Counselor		FL

General Provider Information

NPI Number	:	1710856521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JORDAN HAMMERMAN

Provider Business Mailing Address
First Line	:	145 SEVILLE G
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-2125
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 NE 21ST ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33305-3614
Country	:	US
Telephone Number	:	914-343-8248
Fax Number	:

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

Provider Enumeration Date	:	10/30/2025
Last Update Date	:	10/30/2025

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