Individual
DR. MARK R. GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 10TH STREET N., ST PETERSBURG, FL 33705-1407
(727) 824-7146
(727) 824-7119
Mailing address
PO BOX 12868, ST PETERSBURG, FL 33733-2868
(727) 532-1355
(727) 266-4928
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME20691
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058923300
—
FL
Enumeration date
09/20/2005
Last updated
03/31/2014
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