Provider Demographics
NPI:1568732436
Name:WHITMAN, JORDAN ALEXANDER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:ALEXANDER
Last Name:WHITMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 E WASHINGTON ST
Mailing Address - Street 2:UNIT 301
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3706
Mailing Address - Country:US
Mailing Address - Phone:814-547-1665
Mailing Address - Fax:
Practice Address - Street 1:12028 MAJESTIC BLVD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-2418
Practice Address - Country:US
Practice Address - Phone:727-863-4575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist