Provider Demographics
NPI:1033146907
Name:NADLER, JODI D (PHD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:D
Last Name:NADLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1685 LEE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2262
Mailing Address - Country:US
Mailing Address - Phone:407-303-7991
Mailing Address - Fax:407-303-7803
Practice Address - Street 1:1685 LEE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2262
Practice Address - Country:US
Practice Address - Phone:407-303-7991
Practice Address - Fax:407-303-7803
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPY5236103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
620003409OtherRAILROAD MEDICARE
FL59758OtherBCBS
FL59758OtherBCBS