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General NPI Number Information
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NPI Number | 1396745782
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Entity Type | Individual
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Provider Name | ANTONIO MARIA GORDON JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 5351 SW 8TH ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-2269
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Country | US
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Telephone | 305-901-1191
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Fax | 786-615-5635
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Provider Business Mailing Address
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Address Line | 8210 NW 27TH ST STE 205
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City | DORAL
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State | FL
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Zip | 33122-1900
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Country | US
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Telephone | 305-556-6459
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0028982
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License Number State | FL
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