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Kellroy Gordon

NPI 1184180093 · on the registry since 2019 · sole proprietor

Practice

Address
530 Malabar Rd Sw Apt 202
Palm Bay, FL 32907
Phone
(321) 614-5082

Registry record

Primary taxonomy
372600000X
372600000X
Also registered as
372500000X
374700000X
3747P1801X
376J00000X
376K00000X
Licence states on file
FL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-02-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida