Simon, Jerry Gordon
Simon, Jerry Gordon is an sole proprietor health care provider with primary practice located at 3314 Henderson Blvd Ste 100E , Tampa FL 33609-2999. He recently has only one registered license in Agencies / Home Health, which is considered as his primary health care specialty. Simon, Jerry Gordon can be contacted via phone (813) 391-5909.Contact Information
Primary practice address
3314 Henderson Blvd Ste 100E
Tampa FL 33609-2999
Phone: (813) 391-5909
Fax: (813) 864-6741
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Home Health | 251E00000X |
Profile Details
| NPI number | 1164012993 |
|---|---|
| LBN Legal business name | Simon, Jerry Gordon |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 25th, 2021 |
| Last updated | Jan 25th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164012993 | NPPES |
| Florida | MEDICAID | 104946200 |
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