Joel P Gordon MD PA

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

ME19252 Issued in FL

Legal business name

JOEL P GORDON MD PA

Practice address

424 S Country Club Dr
Lantana, FL 33462-1204

Phone

(561) 585-8183

Fax

(561) 383-2997

NPI assigned

Nov 20, 2007

Last updated

Jan 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ita Campos

Title

Billing Supervisor

Phone

(561) 585-8183

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1346421203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 S COUNTRY CLUB DR",
            "city": "LANTANA",
            "state": "FL",
            "postal_code": "334621204",
            "telephone_number": "561-585-8183",
            "fax_number": "561-383-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 S COUNTRY CLUB DR",
            "city": "LANTANA",
            "state": "FL",
            "postal_code": "334621204",
            "telephone_number": "561-585-8183",
            "fax_number": "561-383-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL P GORDON MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "CAMPOS",
        "authorized_official_first_name": "ITA",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "561-585-8183",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "ME19252",
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "FL",
            "license": "ME19252",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Lantana, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.