SHELLEY MARIE GORDON (NPI# 1235645276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235645276 |
| Entity Type | Individual |
| Full Name | SHELLEY MARIE GORDON |
| Practice Address |
4692 Exploration Ave Lakeland FL 33812-4107 |
| Mailing Address |
5612 Escalante Canyon Dr Kissimmee FL 34758-1729 |
| Practice Telephone | 9102570300 |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2017-12-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
9279224 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568457281 | Shelley Lynn Gordon | Social Worker | 526 Maple Ave, Saratoga Springs, NY 12866-5861 | 2005-09-19 |
| 1649756750 | Shelley Elizabeth Gordon | Speech-Language Pathologist | 12371 S Kirkwood Rd, Stafford, TX 77477-2836 | 2018-07-12 |
| 1841334521 | Shelley Merle Gordon | Internal Medicine | 2100 Webster St, Suite 400, San Francisco, CA 94115-2373 | 2007-02-16 |
| Street Address |
4692 EXPLORATION AVE |
| City | LAKELAND |
| State | FL |
| Zip Code | 33812-4107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376785758 | Cynergy Urgent Care, LLC | Clinic/Center | 4692 Exploration Ave, Lakeland, FL 33812-4107 | 2009-03-31 |
| 1619269362 | Kelly A. Poncheri Dpm Pa | Podiatrist | 4692 Exploration Ave, Lakeland, FL 33812-4107 | 2011-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891036976 | Arlene Nitza Hunt | Counselor | 5421 Us Highway 98 S, Lakeland, FL 33812 | 2013-03-14 |
| 1952648867 | Christopher Benka | Pharmacist | 5185 Us Highway 98 S, Lakeland, FL 33812 | 2013-01-11 |
| 1407105083 | Elena Kan | Dentist | 5644 Vintage View Boulevard, Lakeland, FL 33812 | 2012-08-29 |
| 1760611412 | Blanca Lilia Fernandez | Dentist | 5163 Us Highway 98 S, Lakeland, FL 33812 | 2009-07-02 |
| 1033314190 | Gustavo Alberto De Jesus-gomez | Surgery | 5907 Hillside Heights Dr., Lakeland, FL 33812 | 2007-06-19 |
| 1760600142 | Internal Medicine Specialists Medical Group Pa | Internal Medicine | 3655 Innovation Dr, Lakeland, FL 33812 | 2007-04-23 |
| 1124171475 | Sports and Orthopedic Rehabilitation Services Inc | Clinic/Center | 5155 Us Highway 98 South, Suites 5b&5c, Lakeland, FL 33812 | 2007-01-19 |
| 1356322234 | Carlos M Romero | Family Medicine | 3655 Innovation Drive, Lakeland, FL 33812 | 2005-11-08 |
| 1427055318 | Roxann Castelli Cook | Family Medicine | 2803 Meridian Point Lane, Lakeland, FL 33812 | 2005-07-07 |
| 1316577513 | Ashley Joanne Reckord | Counselor | 5421 Us Highway 98 S, Lakeland, FL 33812 | 2020-01-16 |
| Find all providers in zip 33812 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851906994 | Janine Marie Divincenzo-smith | Nurse Practitioner | 2927 Northbrook Ln, Lakeland, FL 33811-1663 | 2020-09-15 |
| 1225643638 | Erin Garza | Nurse Practitioner | 1606 Lakewood Dr N, Lakeland, FL 33813-3241 | 2020-09-11 |
| 1184240228 | Alexis Michele Ramos | Nurse Practitioner | 858 Rockingham Rd, Lakeland, FL 33809-4044 | 2020-06-24 |
| 1326664632 | Lindsey R Cromer | Nurse Practitioner | 6945 Ashbury Dr, Lakeland, FL 33809-7804 | 2020-06-23 |
| 1043846611 | Amy Melissa Eaton | Nurse Practitioner | 1123 Walt Williams Rd Lot 192, Lakeland, FL 33809-2392 | 2020-03-16 |
| 1265066732 | Komal Meghat | Nurse Practitioner | 707 Arbor Glen Cir Apt 103, Lakeland, FL 33805-2376 | 2020-02-24 |
| 1629609391 | Brooke Nicole Brooks | Nurse Practitioner | 6883 Lake Eaglebrooke Dr, Lakeland, FL 33813-5667 | 2020-01-30 |
| 1568001774 | Theava Ismarella Preston | Nurse Practitioner | 1409 Alameda Dr S, Lakeland, FL 33805-2301 | 2020-01-06 |
| 1497394738 | Denise Thaxter | Nurse Practitioner | 3262 Pebblebrooke Blvd, Lakeland, FL 33810-1305 | 2020-01-03 |
| 1205478724 | Jisha Mathew | Nurse Practitioner | 2636 High Ridge Dr, Lakeland, FL 33812-5883 | 2019-10-16 |
| Find all providers in LAKELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.