Provider Demographics
NPI:1790208551
Name:FROMSON, JORDAN ASHLEY
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ASHLEY
Last Name:FROMSON
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 1:5000 S HIMES AVE APT 533
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-3660
Mailing Address - Country:US
Mailing Address - Phone:860-634-8044
Mailing Address - Fax:
Practice Address - Street 1:8301 PINEHURST DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-5902
Practice Address - Country:US
Practice Address - Phone:860-634-8044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist