Individual
DR. PAUL R. GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1717 S ORANGE AVE STE 100, NEMOURS CHILDRENS CLINIC, ORLANDO,, ORLANDO, FL 32806-2946
(407) 650-7000
(407) 567-5924
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT,, ROCKLAND, DE 19732-0191
(302) 651-6718
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
ME88011
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2677831-00
—
FL
05
—
267783100
—
FL
Enumeration date
06/27/2006
Last updated
09/17/2013
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