Individual
ROBERT HENRY GORDON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1119 SAND CREEK LOOP, OCOEE, FL 34761-1434
(407) 346-9498
Mailing address
PO BOX 617045, ORLANDO, FL 32861-7045
(407) 346-9498
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
236888
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236888
—
FL
Enumeration date
08/17/2020
Last updated
08/17/2020
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