Individual
JORDAN LUPO HEATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4343 NEWBERRY RD STE 1, GAINESVILLE, FL 32607-2822
(352) 331-3502
(352) 331-3488
Mailing address
4881 NW 8TH AVE., SUITE 2, GAINESVILLE, FL 32605-4582
(352) 416-1082
(352) 373-6144
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
ME149410
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111133800
—
FL
Enumeration date
04/10/2013
Last updated
09/01/2021
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