Gordon, Dominique S
Gordon, Dominique S is an sole proprietor health care provider with primary practice located at 7000 Spyglass Ct Ste 220 , Viera FL 32940-7948. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gordon, Dominique S can be contacted via phone (321) 728-6072.Contact Information
Primary practice address
7000 Spyglass Ct Ste 220
Viera FL 32940-7948
Phone: (321) 728-6072
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 11014427 | Florida |
Profile Details
NPI number | 1982204178 |
---|---|
LBN Legal business name | Gordon, Dominique S |
Credentials | MSN, APRN, FNP-C |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Oct 28th, 2020 |
Last updated | Feb 23rd, 2024 - about 10 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1982204178 | NPPES |
Florida | Other | PENDING | MEDICARE HF |
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