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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982204178 NPPES
Florida Other PENDING MEDICARE HF

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