Individual
DR. MICHAEL COUZENS JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2137 LITTLE RD, TRINITY, FL 34655-4410
(727) 372-6760
(727) 372-6808
Mailing address
2137 LITTLE RD, TRINITY, FL 34655-4410
(727) 372-6760
(727) 372-6808
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME86866
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2670593000
—
FL
01
—
71107
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
01/19/2006
Last updated
06/06/2023
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