Individual
DR. ELISE TREFF GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6000 W HIGHWAY 98, PENSACOLA, FL 32512-0001
(850) 452-8108
(850) 452-8979
Mailing address
6000 W HIGHWAY 98, PENSACOLA, FL 32512-0001
(850) 452-8108
(850) 452-8979
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME109095
FL
207QS0010X
Sports Medicine (Family Medicine) Physician
ME109095
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003558200
—
FL
05
—
128079
—
AL
05
—
128081
—
AL
01
—
14E5R
BLUE CROSS BLUE SHIELD
FL
01
—
592-15140
BLUE CROSS BLUE SHIELD
AL
01
—
592-15141
BLUE CROSS BLUE SHIELD
AL
Enumeration date
01/20/2006
Last updated
07/05/2024
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