KELLROY GORDON
Adult Companion
Active
Individual
NPI: 1184180093
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Chore Provider | 372500000X | No | - |
| Technician | 374700000X | No | - |
| Technician - Personal Care Attendant | 3747P1801X | No | - |
| Homemaker | 376J00000X | No | - |
| Nurse's Aide | 376K00000X | No | - |
| Adult Companion | 372600000X | Yes | 195341 (FL) |
Frequently Asked Questions
NPI 1184180093 is the National Provider Identifier for KELLROY GORDON, a Adult Companion provider located in Palm Bay, FL. This NPI was enumerated on February 15, 2019.
KELLROY GORDON practices at 530 MALABAR RD SW APT 202, Palm Bay, FL 32907.
Quick Facts
- NPI
- 1184180093
- Type
- Individual
- Enumerated
- Feb 15, 2019
- Last Updated
- Feb 15, 2019
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