Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME93449 | FL |
Y | 2086S0105X | Surgery of the Hand | ME93449 | FL |
NPI | 1376584615 |
---|---|
Provider Name | Dr. Michael J Gordon |
First Address | Sarasota, FL 34232-2476 |
Second Address | Sarasota, FL 34232-2476 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 06/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
273705100 | (05) | FL |
I40157 | (02) | FL |