Individual
SHARON GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
6511 GUNN HWY, TAMPA, FL 33625-4021
(813) 605-1122
Mailing address
2 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 259-8857
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
11015959
FL
363LF0000X
Family Nurse Practitioner
APRN11015959
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2022138177
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113706100
—
FL
01
—
WITZ4
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/04/2022
Last updated
02/15/2023
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