Individual
GORDON M DICKINSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 NW 12TH AVE, BOX 016960 M851, MIAMI, FL 33136-1005
(305) 243-6484
(305) 243-8470
Mailing address
1611 NW 12TH AVE, BOX 016960 M851, MIAMI, FL 33136-1005
(305) 243-6484
(305) 243-8470
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME30234
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0373729-00
—
FL
Enumeration date
04/18/2006
Last updated
02/04/2019
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