Gordon, Mark William

Gordon, Mark William is an individual health care provider with primary practice located at 7100 W 20Th Ave #703, Hialeah FL 33016-1897. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Gordon, Mark William can be contacted via phone (305) 822-4515.

Contact Information

Primary practice address
7100 W 20Th Ave #703 Hialeah FL 33016-1897
Phone: (305) 822-4515
Fax: (954) 963-3453
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X ME13633 Florida

Profile Details

NPI number 1467441618
LBN Legal business name Gordon, Mark William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Mar 3rd, 2020 - about 6 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 1467441618 NPPES
Florida MEDICAID 056068500

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