Provider Demographics
NPI:1629424841
Name:JORDI, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:JORDI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31044 WRENCREST DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7889
Mailing Address - Country:US
Mailing Address - Phone:813-990-9672
Mailing Address - Fax:
Practice Address - Street 1:31044 WRENCREST DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-7889
Practice Address - Country:US
Practice Address - Phone:813-990-9672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9426629163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse