Individual
JASON GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
205 E RIVO ALTO DR, MIAMI BEACH, FL 33139-1247
(305) 903-0261
Mailing address
205 E RIVO ALTO DR, MIAMI BEACH, FL 33139-1247
(305) 903-0261
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP2407
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP2407
AP2407
—
Enumeration date
02/25/2019
Last updated
02/25/2019
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