Individual
DIANA ELIZABETH GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7305 N MILITARY TRL, RIVIERA BEACH, FL 33410-7417
(561) 422-8262
Mailing address
5262 BELAND DR, LAKE WORTH, FL 33467-7402
(305) 926-6797
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5234948
FL
Other
Enumeration date
03/26/2025
Last updated
03/26/2025
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