Provider Demographics
NPI:1013981653
Name:ZUERNDORFER, GORDON H (MD)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:H
Last Name:ZUERNDORFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 N BELCHER RD
Mailing Address - Street 2:SUITE G-1
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1449
Mailing Address - Country:US
Mailing Address - Phone:727-724-6300
Mailing Address - Fax:727-724-6330
Practice Address - Street 1:1831 N BELCHER RD
Practice Address - Street 2:SUITE G-1
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1449
Practice Address - Country:US
Practice Address - Phone:727-724-6300
Practice Address - Fax:727-724-6330
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55438174400000X
FLME 55438207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0091819OtherCIGNA PROVIDER #
FL249119OtherAVMED PROVIDER #
FL4081512OtherAETNA PROVIDER #
FL4081512OtherAETNA PROVIDER #
FLE74096Medicare UPIN