Individual
DR. MICHAEL A GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3901 NW 79TH AVE STE 105, DORAL, FL 33166-6554
(305) 431-2034
(305) 717-9995
Mailing address
3901 NW 79TH AVE STE 105, DORAL, FL 33166-6554
(305) 431-2034
(305) 717-1558
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2941
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6205305
—
FL
Enumeration date
08/11/2006
Last updated
11/16/2018
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