Individual
DR. JORDAN KRISTOFER TAILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5216 CLAYTON CT, FORT MYERS, FL 33907-2116
(239) 343-8260
(239) 424-2442
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-8260
(239) 343-8261
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME128602
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018006400
—
FL
Enumeration date
02/08/2011
Last updated
03/30/2021
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