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Individual

JOSHUA GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1329 SW 16TH ST, GAINESVILLE, FL 32610
(352) 265-5911
Mailing address
1329 SW 16TH ST, PO BOX 100186, GAINESVILLE, FL 32610-0186
(352) 265-5911

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME135205
FL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
024786700
FL
Enumeration date
04/25/2015
Last updated
08/20/2018
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