Individual
STACY ANN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2025 INDIAN ROCKS RD S, LARGO, FL 33774-1035
(847) 289-9572
(847) 888-5469
Mailing address
3152 LITTLE RD # 162, TRINITY, FL 34655-1864
(847) 289-5727
(847) 888-5469
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
5101021920
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS16125
FL
208D00000X
General Practice Physician
5101021920
MI
Other
Enumeration date
06/05/2015
Last updated
04/22/2021
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