Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | ARNP9194190 | FL |
NPI | 1144611716 |
---|---|
Provider Name | Mr. Hector F Gordillo |
First Address | Miami, FL 33176-8433 |
Second Address | Miami, FL 33136-1005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2015 |
Last Update Date | 06/01/2020 |