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Individual

MARIE JORDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5150 NW MILNER ROAD, PORT SAINT LUCIE, FL 34983
(772) 201-2638
Mailing address
4404 SW SHADD ST, PORT SAINT LUCIE, FL 34953-6093
(772) 201-2638

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
144542
FL

Other

Enumeration date
08/28/2012
Last updated
08/28/2012
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