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Individual

AVI GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7820 PETERS RD STE E100, PLANTATION, FL 33324-4019
(954) 546-4590
Mailing address
3530 N 54TH AVE, HOLLYWOOD, FL 33021-2338

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
10944
FL

Other

Enumeration date
11/16/2020
Last updated
11/16/2020
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