Individual
MICHAEL KEVIN JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
1580 BRANAN FIELD RD, MIDDLEBURG, FL 32068-8427
(904) 214-9102
(904) 214-9054
Mailing address
1580 BRANAN FIELD RD, MIDDLEBURG, FL 32068-8427
(904) 214-9102
(904) 214-9054
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO5422
FL
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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