Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SETH GORDON
ActiveSETH GORDON is a Medical Physician Assistant healthcare provider located in LADY LAKE/VILLAGES, Florida. NPI 1780091280 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · LADY LAKE/VILLAGES, FL
Registration Details
- NPI Number
- 1780091280
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 16, 2014 (12.125506749127 yrs)
- Last Updated
- Oct 22, 2021
- Licenses
-
9113034 (FL)017578 (NY)
Practice Information
- Address
-
805 E CR 466LADY LAKE/VILLAGES, FL, 32159Browse FL providers · Browse ZIP 32159
- Phone
- 3526749218
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
- Additional Specialty
- Medical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.