Provider Demographics
NPI:1053717249
Name:JOURDENAIS, DAVID (DVM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:JOURDENAIS
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4193 N COUNTY ROAD 426
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:FL
Mailing Address - Zip Code:32732-9035
Mailing Address - Country:US
Mailing Address - Phone:407-349-9536
Mailing Address - Fax:
Practice Address - Street 1:4193 N COUNTY ROAD 426
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:FL
Practice Address - Zip Code:32732-9035
Practice Address - Country:US
Practice Address - Phone:407-349-9536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLVM5281174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian