Organization
JOEL P GORDON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ITA CAMPOS (BILLING SUPERVISOR)
(561) 585-8183
Entity
Organization
Contact information
Practice address
424 S COUNTRY CLUB DR, LANTANA, FL 33462-1204
(561) 585-8183
(561) 383-2997
Mailing address
424 S COUNTRY CLUB DR, LANTANA, FL 33462-1204
(561) 585-8183
(561) 383-2997
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
ME19252
FL
305R00000X
Preferred Provider Organization
ME19252
FL
Other
Enumeration date
11/20/2007
Last updated
01/10/2008
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