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Jeremy M Gordon Dc Pa
Multi-Specialty Clinic/Center in Deland, Florida
NPI 1669562500

Jeremy M Gordon Dc Pa is a Multi-Specialty Clinic/Center based in Deland, FL and is specialized in Multi-Specialty. Jeremy M Gordon Dc Pa practices in Deland, FL. The NPI Number for Jeremy M Gordon Dc Pa is 1669562500 and holds a License No. CH7770 (Florida).

The current practice location address for Jeremy M Gordon Dc Pa is 905 N Stone St, Deland, FL and can be reached out via phone at 386-734-9995 and via fax at 386-734-9949.

Location: 905 N Stone St, Deland, FL, 32720-2521
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1669562500
Provider Name
Jeremy M Gordon Dc Pa
Credential
Provider Entity Type
Organization
Address
905 N Stone St, Deland, FL, 32720-2521
Phone Number
386-734-9995
Fax Number
386-734-9949
Provider Enumeration Date
10/13/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
55875 01 FL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
905 N Stone St
City
Deland
State
Florida
Zip
32720-2521
Phone Number
386-734-9995
Fax Number
386-734-9949
person
Provider Business Mailing Address Details
Address
905 N Stone St
City
Deland
State
Florida
Zip
32720-2521
Phone Number
386-734-9995
Fax Number
386-734-9949
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
261QM1300X
License No.
CH7770 (Florida)
Definition
Definition to come...
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