Individual
CAROLE LYNN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12109 COUNTY ROAD 103 STE 2, OXFORD, FL 34484-2951
(352) 259-4400
(352) 787-0370
Mailing address
12109 COUNTY ROAD 103, OXFORD, FL 34484-2951
(352) 205-8981
(352) 391-6498
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
G2973
TX
208800000X
Urology Physician
Primary
ME 110346
FL
2088P0231X
Pediatric Urology Physician
G2973
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032766001
—
TX
Enumeration date
06/12/2006
Last updated
01/18/2021
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