Organization
DR. GORDON J. PENN AND ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON J PENN O.D. (CEO)
(321) 259-4393
Entity
Organization
Contact information
Practice address
8500 N WICKHAM RD, VIERA, FL 32940-6600
(321) 259-4393
(321) 242-6132
Mailing address
8500 N WICKHAM RD, VIERA, FL 32940-6600
(321) 259-4393
(321) 242-6132
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2710
FL
Other
Enumeration date
01/12/2012
Last updated
03/13/2012
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