MEDICARE: DR. HAROLD RICHARD JORDAN 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
1	2084P0800X	Psychiatry Physician	60536	MA
2	2084P0800X	Psychiatry Physician	ME141451	FL

General Provider Information

NPI Number	:	1952382723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAROLD RICHARD JORDAN MD

Provider Business Mailing Address
First Line	:	50 MINORCA AVE APT 1604
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4570
Country	:	US
Telephone Number	:	786-600-3025
Fax Number	:	413-727-3340

Provider Business Practice Location Address
First Line	:	50 MINORCA AVE APT 1604
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-4570
Country	:	US
Telephone Number	:	786-600-3025
Fax Number	:	413-727-3340

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	06/22/2023

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