Kevin B Gordon, ATC
Specialist/Technologist, Athletic Trainer in Tampa, FL. Individual provider (NPI-1).
NPI number1649787367
StatusActive
Last updated in NPPESJan 3, 2018
Details
- NPI
- 1649787367
- Entity type
- Individual (NPI-1)
- Name
- Kevin B Gordon
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 3, 2018
- Last updated
- Jan 3, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AL2164 | FL | Yes |
Practice location
3618 Madaca LnTampa, FL 33618-2057
Phone 813-978-9700
Mailing address
13020 N Telecom PkwyTemple Terrace, FL 33637-0925
Phone 813-978-9700
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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