Most Relevant Information
Provider Data
| NPI Number: | 1003496258 |
| Provider Name: | AMBER GORDON DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/12/2021 |
| Last Updated: | 04/12/2021 |
Provider Practice Location
10853 TRAILING VINE DR
TAMPA
FL
336109742
Practice Location Phone/Fax
| Phone: | 5085214873 |
| Fax: |
Provider Mailing Location
10853 TRAILING VINE DR
TAMPA
FL
336109742
Provider Mailing Phone/Fax
| Phone: | 5085214873 |
| Fax: |