Organization
GULFCOAST FOOT & ANKLE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICKEY EDSON GORDON D.P.M. (OWNER/PRESIDENT)
(239) 566-8800
Entity
Organization
Contact information
Practice address
11181 HEALTH PARK BOULEVARD, SUITE #1180, NAPLES, FL 34110-5738
(239) 566-8800
(239) 566-8778
Mailing address
P.O. BOX 110759, NAPLES, FL 34108-0113
(239) 566-8800
(239) 566-8778
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO0002638
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093729592
INDIVIDUAL NPI
—
01
—
1285854448
NPI
FL
01
—
1689644882
INDIVIDUAL NPI
—
Enumeration date
04/27/2007
Last updated
08/04/2015
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