Robert Henry Gordon Sr.

Primary specialty

HomemakerTaxonomy code 376J00000X

License

236888 Issued in FL

Practice address

1119 Sand Creek Loop
Ocoee, FL 34761-1434

Phone

(407) 346-9498

NPI assigned

Aug 17, 2020

Last updated

Aug 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1871105429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617045",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328617045",
            "telephone_number": "407-346-9498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 SAND CREEK LOOP",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347611434",
            "telephone_number": "407-346-9498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ROBERT",
        "middle_name": "HENRY",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "FL",
            "license": "236888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236888",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Masiel Gonzalez Quevedo Espineta
• Yaneliza S Gonzalez
• Good Homes Pharmacy, LLC
• Charles Goodnough, PA-C
• Carroll Lolita Gordon
• Wilmise Mimise Gowins, LCSW
• Gracefully Aging LLC
• Gracefully Aging LLC
• Gracepoint ABA
• Jessica N Grande, PT, DPT, CSCS

• Homemaker in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Homemaker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.