Individual
ANDRES GORDILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S CCC-SLP
Contact information
Practice address
10910 CLARKSVILLE PIKE, ELLICOTT CITY, MD 21042-6106
(561) 305-7975
Mailing address
10910 CLARKSVILLE PIKE, ELLICOTT CITY, MD 21042-6106
(410) 313-6600
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10895
MD
235Z00000X
Speech-Language Pathologist
SA15492
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019549700
—
FL
Enumeration date
12/20/2016
Last updated
08/20/2024
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