Dr. Gordon J. Penn and Associates PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

2710 Issued in FL

Legal business name

DR. GORDON J. PENN AND ASSOCIATES PA

Practice address

8500 N Wickham Rd
Viera, FL 32940-6600

Phone

(321) 259-4393

Fax

(321) 242-6132

NPI assigned

Jan 12, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gordon J Penn, O.D.NPI 1417960881

Title

Ceo

Phone

(321) 259-4393

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gordon J Penn, O.D.

  • Corneal and Contact Management Optometrist
  • Viera, FL
  • NPI 1417960881
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1184994733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8500 N WICKHAM RD",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329406600",
            "telephone_number": "321-259-4393",
            "fax_number": "321-242-6132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 N WICKHAM RD",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329406600",
            "telephone_number": "321-259-4393",
            "fax_number": "321-242-6132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. GORDON J. PENN AND ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "PENN",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-259-4393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "2710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dara M Diamond, APRN
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• Heidi Elizabeth Dowling, MS, CCC-SLP
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• Mark Steven Dresner, M.D.
• Ashley Duclos
• Kelly Faust Duke Jr., O.D.
• Delbert Ernest Duncklee Jr., LCSW

• Optometrist in Viera, FL
• Providers in Viera, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.