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General NPI Number Information
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NPI Number | 1831053792
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Entity Type | Individual
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Provider Name | RAYMONDO B. GORDON RN
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Gender | Male
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1216 2ND ST SW
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City | ROCHESTER
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State | MN
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Zip | 55902-1906
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Country | US
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Telephone | 507-255-6926
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Fax |
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Provider Business Mailing Address
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Address Line | 537 NORTHERN HILLS DR NE APT 32
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City | ROCHESTER
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State | MN
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Zip | 55906-4035
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Country | US
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Telephone | 507-255-6926
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R191305-7
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License Number State | MN
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