Gordon, Jonathan E

Gordon, Jonathan E is an individual health care provider with primary practice located at 4320 W Broward Blvd Suite 2, Plantation FL 33317-3756. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gordon, Jonathan E can be contacted via phone (954) 583-1311.

Contact Information

Primary practice address
4320 W Broward Blvd Suite 2 Plantation FL 33317-3756
Phone: (954) 583-1311
Fax: (954) 587-4448
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC 3471 Florida

Profile Details

NPI number 1336173418
LBN Legal business name Gordon, Jonathan E
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Jun 11th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336173418 NPPES
Florida MEDICAID 003618900

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