Individual
DR. MARK WILLIAM GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7100 W 20TH AVE, #703, HIALEAH, FL 33016-1897
(305) 822-4515
(954) 963-3453
Mailing address
2301 N UNIVERSITY DR, #203, PEMBROKE PINES, FL 33024-3617
(954) 964-1490
(954) 963-3453
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME13633
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056068500
—
FL
Enumeration date
10/20/2005
Last updated
03/03/2020
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