| Doctor Name: | DR. JORDAN DITCHEK |
| NPI Number: | 1063415248 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME81781 |
| Business Practice Address: | 3501 Johnson St Hollywood, FL - 330215421 |
| Business Phone Number: | 9549872000 |
| Business Fax Number: | 9544376628 |
| Mailing Address: | 9050 Pines Blvd, Ste 200 PEMBROKE PINES |
| State: | FL |
| Postal Code: | 330246456 |
| Phone Number: | 9544374800 |
| Fax Number: | 9544376628 |
| NPI Enumeration Date: | 05/23/2005 |
| NPI Last Update Date: | 11/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | ME81781 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |