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NPI Code Detail

MEDICARE: WHITNEY GORDON

MEDICARE: WHITNEY GORDON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS57321FL

General Provider Information

NPI Number : 1144820937
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY GORDON
Provider Business Mailing Address
First Line : 2268 WABASH TRL
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32303-8370
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4400 W TENNESSEE ST
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32304-1029
Country : US
Telephone Number : 850-574-4613
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2020
Last Update Date : 10/29/2020

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Directions to “ WHITNEY GORDON ” Practice Location

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