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General NPI Number Information
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NPI Number | 1013905629
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Entity Type | Individual
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Provider Name | MICHAEL D. GORDON M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 3191 E SEMORAN BLVD
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City | APOPKA
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State | FL
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Zip | 32703-5943
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Country | US
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Telephone | 407-788-6500
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Fax | 407-869-9400
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Provider Business Mailing Address
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Address Line | 3191 E SEMORAN BLVD
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City | APOPKA
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State | FL
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Zip | 32703-5943
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Country | US
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Telephone | 407-788-6500
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Fax | 407-869-9400
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | ME0047490
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0047490
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License Number State | FL
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