KRYSTAL GORDON (NPI# 1568022523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568022523 |
| Entity Type | Individual |
| Full Name | KRYSTAL GORDON |
| Credential | ARNP |
| Practice Address |
4300 Kings Hwy Ste 500 Port Charlotte FL 33980-2953 |
| Mailing Address |
Po Box 919771 Orlando FL 32891-9771 |
| Practice Telephone | 8443427935 |
| Practice Fax Number | 9417646176 |
| Mailing Telephone | 2392783600 |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2020-09-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0222X |
Nurse Practitioner Specialization: Pediatrics, Critical Care |
APRN11002846 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366513012 | Krystal Mi'chal Gordon | Social Worker | 546 W Compton Blvd, Compton, CA 90220-3011 | 2006-11-13 |
| Street Address |
4300 KINGS HWY STE 500 |
| City | PORT CHARLOTTE |
| State | FL |
| Zip Code | 33980-2953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063919975 | Nataly Salazar | Dentist | 4300 Kings Hwy Ste 500, Port Charlotte, FL 33980-2953 | 2018-04-07 |
| 1720572027 | Brett Goldstein | Dentist | 4300 Kings Hwy Ste 500, Port Charlotte, FL 33980-2953 | 2018-06-20 |
| 1043702756 | Sirirat Seebunpang | Dentist | 4300 Kings Hwy Ste 500, Port Charlotte, FL 33980-2953 | 2018-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144699646 | Raymond B Hendricks | Custodial Care Facility | 1306 Annette St, Port Charlotte, FL 33980 | 2015-09-15 |
| 1649616517 | Anne Yvonne Clarke | Nurse's Aide | 3378 Idlewild Street, Port Charlotte, FL 33980 | 2013-05-17 |
| 1427395680 | John F Guarino Md Pa | Surgery | 4245 Kings Hwy, Unit A, Port Charlotte, FL 33980 | 2013-01-08 |
| 1497049027 | Patricia Ann Drow | Occupational Therapist | 24469 Manchester Trail, Port Charlotte, FL 33980 | 2011-05-31 |
| 1811221484 | Amanda K Huffman | Clinical Nurse Specialist | 22655 Bayshore Rd Ste 130, Port Charlotte, FL 33980 | 2009-09-29 |
| 1093967739 | Donna Olson | Nurse Practitioner | 1100 Loveland Boulevard, Port Charlotte, FL 33980 | 2008-10-14 |
| 1821278029 | Paula Marie Allison | Dietitian, Registered | 23422 Burlingame Ave, Port Charlotte, FL 33980 | 2007-11-06 |
| 1689865891 | Keith Anthony Williams | Physical Medicine & Rehabilitation | 4265 Laura Street, Port Charlotte, FL 33980 | 2007-08-05 |
| 1578685491 | Richard Michael Cocchieri | Dentist | Florida Department of Health In Charlotte County, 1100 Loveland Boulevard, Port Charlotte, FL 33980 | 2007-04-03 |
| 1417989328 | John F Guarino | Surgery | 4245 Kings Highway, Unit A, Port Charlotte, FL 33980 | 2006-07-07 |
| Find all providers in zip 33980 | ||||
| Taxonomy Code | 363LP0222X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417576398 | Julia Margot Guild | Nurse Practitioner | 5259 Ellery Ter, West Palm Beach, FL 33417-8359 | 2020-04-10 |
| 1730536855 | Aimee Forster | Nurse Practitioner | 12567 23rd St E, Parrish, FL 34219-6907 | 2016-05-18 |
| 1245298181 | Cheryl Lynn Silbernagel | Nurse Practitioner | 3003 West Mlk Blvd, 3rd Floor Mab, Tampa, FL 33607 | 2006-05-02 |
| 1447869938 | Caroline Boudet Johnson | Nurse Practitioner | 92 W Miller St, Orlando, FL 32806-2032 | 2020-07-30 |
| 1699398461 | Kerri Lynn Telibasa | Nurse Practitioner | 92 W Miller St, Orlando, FL 32806-2032 | 2020-05-27 |
| 1164043667 | Breanna Nicole James | Nurse Practitioner | 800 Prudential Dr, Jacksonville, FL 32207-8211 | 2020-05-06 |
| 1831742691 | Michael Allan Thompson | Nurse Practitioner | 1600 Sw Archer Rd Unit 10-2, Gainesville, FL 32610-3003 | 2019-07-22 |
| 1427528017 | Jessica Albaugh | Nurse Practitioner | 3003 W Mlk Blvd, 3rd Floor Medical Arts Building, Tampa, FL 33607 | 2018-11-27 |
| 1235668922 | Jill Allison Jones | Nurse Practitioner | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2017-06-07 |
| 1972031128 | Kristina Kalle Darville | Nurse Practitioner | 501 6th Ave S Dept, St Petersburg, FL 33701-4634 | 2017-06-01 |
| Find all providers with the same taxonomy | ||||
| City | PORT CHARLOTTE |
| Zip Code | 33980 |
Please comment or provide details below to improve the information on KRYSTAL GORDON.
| 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.