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General NPI Number Information
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NPI Number | 1346414364
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Entity Type | Organization
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Legal Business Name | HARRY F GORDON, MD, LLC
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Dates
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Enumeration Date | 04/22/2008
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 1601 PARK CENTER DR SUITES 3,4,5
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City | ORLANDO
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State | FL
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Zip | 32835-5700
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Country | US
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Telephone | 407-522-4555
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Fax | 407-226-2898
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Provider Business Mailing Address
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Address Line | 1601 PARK CENTER DR STE 345
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City | ORLANDO
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State | FL
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Zip | 32835-5700
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Country | US
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Telephone | 407-351-3673
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Fax | 407-226-2898
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | MRS. RUCHI AHLUWALIA
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Credential |
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Telephone | 407-274-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME56591
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License Number State | FL
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