Provider Demographics
NPI:1235508672
Name:JOWERS, JORDAN LINDSAY (PA)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:LINDSAY
Last Name:JOWERS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ALEXANDRIA BLVD
Mailing Address - Street 2:STE1
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8298
Mailing Address - Country:US
Mailing Address - Phone:407-359-7997
Mailing Address - Fax:407-359-6662
Practice Address - Street 1:100 ALEXANDRIA BLVD
Practice Address - Street 2:STE 1
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8298
Practice Address - Country:US
Practice Address - Phone:407-359-7997
Practice Address - Fax:407-359-6662
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPAT9109007363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical