Individual
DR. MICHAEL BRIAN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD,PHD
Contact information
Practice address
1600 S ANDREWS AVE, DEPARTMENT OF RADIOLOGY, FORT LAUDERDALE, FL 33316-2510
(954) 355-5500
Mailing address
1801 S PERIMETER RD, STE 180, FORT LAUDERDALE, FL 33309-7140
(954) 839-8080
(954) 839-8081
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME100880
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001148100
—
FL
01
—
149S7
BC BS OF FLORIDA
FL
Enumeration date
03/27/2007
Last updated
09/21/2017
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