CHARLES S GORDON (NPI# 1679516124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679516124 |
| Entity Type | Individual |
| Full Name | CHARLES S GORDON |
| Credential | M.D. |
| Practice Address |
512 Nokomis Ave S Venice FL 34285-2817 |
| Mailing Address |
Po Box 1508 Venice FL 34284-1508 |
| Practice Telephone | 9414887781 |
| Practice Fax Number | 9414849235 |
| Mailing Telephone | 9414887781 |
| Mailing Fax Number | 9414849235 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME0068812 | FL | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
ME0068812 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 265320600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942692769 | Charles Gordon | Physical Therapist | 29 Center St Ste 1, Goffstown, NH 03045-2948 | 2015-03-03 |
| 1811019268 | Charles Thomas Gordon IIi | Psychiatry & Neurology | 11204 Farmland Dr, Rockville, MD 20852-4522 | 2007-04-05 |
| 1821103631 | Charles Albert Gordon | Physical Medicine & Rehabilitation | 1059 S Fairfax Ave, Los Angeles, CA 90019-4402 | 2006-08-20 |
| 1831164722 | Charles G. Gordon | Dentist | 1026 Eagleridge Blvd, Pueblo, CO 81008-2130 | 2006-02-22 |
| 1649243890 | Charles F Gordon | Anesthesiology | 9 Old Plank Rd Ste 100, Clifton Park, NY 12065-3107 | 2006-02-08 |
| 1326049529 | Charles Richard Gordon | Family Medicine | 200 Cabrini Blvd, Suite 17, New York, NY 10033-1100 | 2005-08-10 |
| 1750858700 | Charles Gordon | Case Manager/Care Coordinator | 4269 Pearl Rd, Cleveland, OH 44109-4234 | 2018-10-29 |
| 1134642655 | Charles Gordon | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2017-07-18 |
| 1114382025 | Charles Gordon Jr. | Physician Assistant | 315 S Manning Blvd, Albany, NY 12208-1707 | 2015-12-18 |
| 1275825135 | Charles Marvin Gordon Jr. | Orthopaedic Surgery | 1505 Daphne Ave, Daphne, AL 36526 | 2011-05-11 |
| Street Address |
512 NOKOMIS AVE S |
| City | VENICE |
| State | FL |
| Zip Code | 34285-2817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083662316 | Josiah Bancroft | Radiology | 512 Nokomis Ave S, Venice, FL 34285-2899 | 2006-05-05 |
| 1437492840 | Travis Alan Carter | Radiology | 512 Nokomis Ave S, Venice, FL 34285-2899 | 2013-04-03 |
| 1730116872 | Charles J Davenport | Radiology | 512 Nokomis Ave S, Venice, FL 34285-2817 | 2006-06-26 |
| 1184667024 | Phillip M Mihm | Radiology | 512 Nokomis Ave S, Venice, FL 34285-2817 | 2006-06-14 |
| 1003850934 | Gary D Wright | Radiology | 512 Nokomis Ave S, Venice, FL 34285-2817 | 2006-06-14 |
| 1366484347 | Melecito E Baga | Radiology | 512 Nokomis Ave S, Venice, FL 34285-2817 | 2006-06-12 |
| 1508803966 | Radiology Associates of Venice and Englewood Pa | Radiology | 512 Nokomis Ave S, Venice, FL 34285-2817 | 2006-06-02 |
| 1528005048 | Eugenio Erquiaga | Radiology | 512 Nokomis Ave S, Venice, FL 34285-2817 | 2006-06-01 |
| 1861439325 | Craig T Reiheld | Radiology | 512 Nokomis Ave S, Venice, FL 34285-2817 | 2006-06-01 |
| 1154368694 | Eric M Vihlen | Radiology | 512 Nokomis Ave S, Venice, FL 34285-2817 | 2006-06-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972139871 | Safe Haven Counseling LLC | Clinic/Center | 333 S. Tamiami Trail, Suite 284, Venice, FL 34285 | 2020-03-23 |
| 1518445857 | American Eagle Venice Island LLC | Alzheimer Center (Dementia Center) | 1200 Avenida Del Circo, Venice, FL 34285 | 2018-07-30 |
| 1851886915 | Jafet Baxter | Nurse Practitioner | 333 South Tamiami Trail Suite 307, Venice, FL 34285 | 2018-06-29 |
| 1023538345 | Mary Laurie | Durable Medical Equipment & Medical Supplies | 234 Tamiami Trail S, Venice, FL 34285 | 2017-06-27 |
| 1689121584 | The Sky Family Ymca Inc. | Health Educator | 701 Center Rd, Venice, FL 34285 | 2016-09-08 |
| 1033576137 | Broy Enterprises Inc. | Durable Medical Equipment & Medical Supplies | 1205 U.S. 41 Bypass South, Venice, FL 34285 | 2016-01-20 |
| 1629444013 | George C Chamberlain | Hearing Instrument Specialist | 836 Pinebrook Rd Ste D5, Venice, FL 34285 | 2015-08-19 |
| 1801287123 | Cory O'neel | Pharmacist | 1229 Us Highway 41 Byp S, Venice, FL 34285 | 2015-02-09 |
| 1831516418 | Home Detox Inc | Counselor | 530 Us 41 Bypass So, Unit 12b, Venice, FL 34285 | 2014-03-21 |
| 1922440742 | Lynn Zittel | Occupational Therapist | 841 Venetia Bay Blvd, Venice, FL 34285 | 2013-07-22 |
| Find all providers in zip 34285 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
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| 1164060497 | Advanced Vascular Cardiac & Veins, Pllc | Radiology | 7480 Bird Rd Ste 560, Miami, FL 33155-6657 | 2019-12-17 |
| 1801437041 | Premier Interventional & Diagnostic Radiology, Corp | Radiology | 8495 Sw 56th St, Miami, FL 33155-5426 | 2019-09-30 |
| 1003476169 | Hss-florida Physicians LLC | Radiology | 1395 S State Road 7 Ste 410, Wellington, FL 33414-9327 | 2019-06-19 |
| 1003302712 | Ocuflow Doppler LLC | Radiology | 1855 Veterans Park Drive, Naples, FL 34109 | 2018-07-05 |
| 1972006351 | Minimally Invasive Vascular, Inc | Radiology | 2720 Us Highway 1 S Ste C, St Augustine, FL 32086-6301 | 2018-03-13 |
| 1124530761 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 313 W Bass St, Kissimmee, FL 34741-5011 | 2017-11-03 |
| 1942727516 | Inspired Interventional Radiology Services LLC | Radiology | 11011 Sheridan St Ste 102, Hollywood, FL 33026-1501 | 2017-08-24 |
| 1386004901 | Precision Medical Imaging and Therapeutic Institute LLC | Radiology | 2540 Green Forest Ln, Suite #101, Lutz, FL 33558-5388 | 2016-02-24 |
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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.