Provider Demographics
NPI:1326492893
Name:ELMAN, JORDAN BENJAMIN (MD)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:BENJAMIN
Last Name:ELMAN
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 1:299 E CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4218
Mailing Address - Country:US
Mailing Address - Phone:973-885-5829
Mailing Address - Fax:
Practice Address - Street 1:3001 CORAL HILLS DR STE 250
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4175
Practice Address - Country:US
Practice Address - Phone:954-721-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-20
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME154686207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program