Individual
DR. PRODROMOS GORDON BORBOROGLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
575 S WICKHAM RD, SUITE A, WEST MELBOURNE, FL 32904-1170
(321) 308-5060
(321) 308-5069
Mailing address
2200 W EAU GALLIE BLVD, SUITE 200, MELBOURNE, FL 32935-3165
(321) 308-5060
(321) 308-5069
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME99271
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280092600
—
FL
01
—
P00631812
RR MEDICARE
FL
Enumeration date
03/24/2006
Last updated
05/19/2015
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