MEDICARE: CHRISTINE MAY GORDON ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	9357697	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902322613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE MAY GORDON ARNP

Provider Business Mailing Address
First Line	:	4753 NW 115TH AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-2154
Country	:	US
Telephone Number	:	954-592-4836
Fax Number	:	954-753-1883

Provider Business Practice Location Address
First Line	:	4753 NW 115TH AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-2154
Country	:	US
Telephone Number	:	954-592-4836
Fax Number	:	954-753-1883

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2017
Last Update Date	:	08/15/2017

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