Shane Jordan

NPI 1104145606 - Pharmacist - 183500000X

NPI Details
NPI 1104145606
Gender Male
Enumeration Date 05/24/2010
Last Updated 05/24/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
4445 US HIGHWAY 98 N
LAKELAND FL, 33809-0402, US
Phone (863) 815-2343
Fax
Business Location
1834 GREY FOX DR
LAKELAND FL, 33810-2069, US
Phone
Fax
Toxanomy
Taxonomy Code 183500000X
License State Florida
License Number PS45173
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According to our database, Dr. Shane Jordan NPI is 1104145606, taxonomy code is 183500000X and license number is PS45173, license state is located at Florida. Shane Jordan physically located at 4445 Us Highway 98 N, Lakeland FL, 33809-0402. NPI Number Shane Jordan has the Individual type.

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1104145606 NPI number is provided on an as is basis without warranty of any kind. 1104145606 is maintained by the National Plan & Provider Enumeration System. The contents of Shane Jordan are for informational purposes only.