Provider Demographics
NPI:1134106016
Name:GRABEL, JORDAN C (MD)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:C
Last Name:GRABEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N FLAGLER DR
Mailing Address - Street 2:SUITE 5900
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3404
Mailing Address - Country:US
Mailing Address - Phone:561-833-6388
Mailing Address - Fax:561-833-6353
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:SUITE 5900
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3404
Practice Address - Country:US
Practice Address - Phone:561-833-6388
Practice Address - Fax:561-833-6353
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0059569207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12388OtherPROVIDER NUMBER
FL12388OtherPROVIDER NUMBER