Provider Demographics
NPI:1124990767
Name:SEARCY, JORDAN ANDERSON (CAA)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ANDERSON
Last Name:SEARCY
Suffix:
Gender:M
Credentials:CAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3868 COASTAL COVE CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-0003
Mailing Address - Country:US
Mailing Address - Phone:812-989-3096
Mailing Address - Fax:
Practice Address - Street 1:3868 COASTAL COVE CIR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-0003
Practice Address - Country:US
Practice Address - Phone:812-989-3096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program