Individual
MR. JEREMY MARC GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0111
Mailing address
4113 BLUFF HARBOR WAY, WELLINGTON, FL 33449-8320
(561) 319-6177
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
FL
Other
Enumeration date
07/12/2019
Last updated
09/11/2019
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