Individual
DR. GORDON J PENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
8500 N WICKHAM RD, VIERA, FL 32940-6600
(321) 259-4393
(321) 242-6132
Mailing address
8500 N WICKHAM RD, VIERA, FL 32940-6600
(321) 259-4393
(321) 242-6132
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
2710
FL
Other
Enumeration date
08/15/2006
Last updated
10/07/2011
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