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General NPI Number Information
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NPI Number | 1295755254
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Entity Type | Individual
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Provider Name | RICHARD DENNIS GORDON M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 14532 BELMONT TRCE
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City | WELLINGTON
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State | FL
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Zip | 33414-7627
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Country | US
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Telephone | 215-990-7128
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Fax |
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Provider Business Mailing Address
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Address Line | 14532 BELMONT TRCE
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City | WELLINGTON
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State | FL
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Zip | 33414-7627
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Country | US
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Telephone | 215-990-7128
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MA37250
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD023383E
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | ME126106
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License Number State | FL
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