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General NPI Number Information
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NPI Number | 1144611716
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Entity Type | Individual
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Provider Name | HECTOR F GORDILLO APRN
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Gender | Male
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Dates
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Enumeration Date | 02/18/2015
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 1611 NW 12TH AVE STE C402
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City | MIAMI
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State | FL
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Zip | 33136-1005
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Country | US
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Telephone | 305-585-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 11337 SW 112TH CIRCLE LN N
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City | MIAMI
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State | FL
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Zip | 33176-8433
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Country | US
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Telephone | 786-877-2410
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Fax |
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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 | 363LC0200X
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Taxonomy Name | Critical Care Medicine Nurse Practitioner
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License Number | ARNP9194190
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN9194190
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License Number State | FL
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