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General NPI Number Information
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NPI Number | 1821275462
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Entity Type | Individual
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Provider Name | CLEOPATRA T GORDON-PUSEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/25/2008
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 222 S FLAMINGO RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1721
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Country | US
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Telephone | 954-392-9026
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Fax | 954-357-2353
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Provider Business Mailing Address
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Address Line | PO BOX 260816
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-7816
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Country | US
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Telephone | 954-392-9026
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Fax | 954-357-2353
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME99822
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License Number State | FL
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