Individual
SETH GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
805 E CR 466, LADY LAKE/VILLAGES, FL 32159
(352) 674-9218
Mailing address
805 E CR 466, LADY LAKE/VILLAGES, FL 32159
(352) 674-9218
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
017578
NY
363AM0700X
Medical Physician Assistant
Primary
9113034
FL
Other
Enumeration date
07/16/2014
Last updated
10/22/2021
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