Individual
JORDAN M APPENZELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
62 COLUMBIA ST, ORLANDO, FL 32806-1115
(407) 515-2420
Mailing address
62 COLUMBIA ST, ORLANDO, FL 32806-1115
(321) 843-5851
(321) 843-1673
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
AA1023
FL
367H00000X
Anesthesiologist Assistant
Primary
AA1023
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124556100
—
FL
Enumeration date
07/15/2024
Last updated
10/29/2024
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