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Organization

GORDON CLINIC-ANTONIO GORDON MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANTONIO M. GORDON JR. MD (PRESIDENT)
(305) 556-6459
Entity
Organization

Contact information

Practice address
344 W 65TH ST, SUITE 201-204, HIALEAH, FL 33012-6719
(305) 556-6459
(305) 556-9623
Mailing address
344 W 65TH ST, SUITE 201-204, HIALEAH, FL 33012-6719
(305) 556-6459
(305) 556-9623

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
FL
207R00000X
Internal Medicine Physician
0028982
FL
207RC0000X
Cardiovascular Disease Physician
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036786900
FL
01
79262
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/01/2005
Last updated
11/30/2010
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