Individual
CHARLES J JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15955 SW 96TH ST, SUITE 401, MIAMI, FL 33196-1271
(786) 467-3430
(786) 533-9695
Mailing address
PO BOX 100905, ATLANTA, GA 30384-0905
(786) 467-3430
(786) 533-9695
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME108949
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003735300
—
FL
01
—
14CQ8
BCBS
FL
01
—
5121218
CIGNA
FL
01
—
9510656
AETNA
FL
Enumeration date
06/19/2007
Last updated
10/28/2022
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