Gordon, Mickey E.

Gordon, Mickey E. is an individual health care provider with primary practice located at 9955 Tamiami Trl N Suite 1, Naples FL 34108-1914. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Gordon, Mickey E. can be contacted via phone (239) 566-8800.

Contact Information

Primary practice address
9955 Tamiami Trl N Suite 1 Naples FL 34108-1914
Phone: (239) 566-8800
Fax: (239) 566-8778
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO2638 Florida
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 0936 Michigan
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 187 New Mexico

Profile Details

NPI number 1689644882
LBN Legal business name Gordon, Mickey E.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Mar 31st, 2008 - about 18 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 1689644882 NPPES
Florida Other 5782609 AETNA PROVIDER #
Florida Other 65543 AETNA PROVIDER #
Florida Other K6801 AETNA PROVIDER #
Florida Other 0936 AETNA PROVIDER #
Florida Other 187 AETNA PROVIDER #
Florida Other PO2638 AETNA PROVIDER #

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