Most Relevant Information
Provider Data
| NPI Number: | 1003560194 |
| Provider Name: | JORDAN ANTONIO FACEY PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA9115647 |
Most Important Dates
| Enumeration Date: | 02/08/2022 |
| Last Updated: | 09/18/2023 |
Provider Practice Location
14601 HOPE CENTER LOOP
FORT MYERS
FL
339124707
Practice Location Phone/Fax
| Phone: | 2393347000 |
| Fax: | 2393347070 |
Provider Mailing Location
14601 HOPE CENTER LOOP
FORT MYERS
FL
339124707
Provider Mailing Phone/Fax
| Phone: | 2393347000 |
| Fax: | 2393347070 |