Individual
JANEEN RENE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
311 N CLYDE MORRIS BLVD STE 510, DAYTONA BEACH, FL 32114-2757
(386) 241-1020
(386) 241-1022
Mailing address
PO BOX 100108, GAINESVILLE, FL 32610-0108
(352) 273-5670
(352) 273-5683
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME112412
FL
2086S0102X
Surgical Critical Care Physician
Primary
ME112412
FL
390200000X
Student in an Organized Health Care Education/Training Program
TL-877
CO
Other
Enumeration date
01/26/2007
Last updated
02/23/2022
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