| Doctor Name: | STEVEN JORDAN |
| NPI Number: | 1538438619 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | DO3073 |
| Business Practice Address: | 235 Commercial Blvd Lauderdale By The Sea, FL - 333084452 |
| Business Phone Number: | 9544915818 |
| Business Fax Number: | 9544915819 |
| Mailing Address: | 235 Commercial Blvd, LAUDERDALE BY THE SEA |
| State: | FL |
| Postal Code: | 333084452 |
| Phone Number: | 9544915818 |
| Fax Number: | 9544915819 |
| NPI Enumeration Date: | 12/20/2011 |
| NPI Last Update Date: | 12/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | DO3073 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |