Provider Demographics
NPI:1386725331
Name:HOPKINS, JORDAN ERIC (MD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ERIC
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 UNIVERSITY PKWY STE 204A
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2973
Mailing Address - Country:US
Mailing Address - Phone:941-355-5336
Mailing Address - Fax:941-355-5338
Practice Address - Street 1:2401 UNIVERSITY PKWY STE 204A
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2973
Practice Address - Country:US
Practice Address - Phone:813-480-2332
Practice Address - Fax:941-761-6000
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL96050207RC0000X
FLME96050207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004104100Medicaid
FLDM641XMedicare PIN
FLDM641XMedicare PIN