# GORDON, DOMINIC J

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700760790
- **Authorized official:** DOMINIC J GORDON (ADMINISTRATOR)
- **Authorized official phone:** (813) 284-4788

## Contact information

- **Practice address:** 1319 N TAYLOR RD, BRANDON, FL 33510-2422
- **Practice address phone:** (813) 485-6844
- **Mailing address:** 1319 N TAYLOR RD, BRANDON, FL 33510-2422
- **Mailing address phone:** (813) 284-4788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | — | Yes |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/02/2025
- **Last updated:** 04/30/2026