Provider Demographics
NPI:1023100252
Name:ORDON, RICHARD Z (PA-C)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:Z
Last Name:ORDON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 BUDINGER AVE STE C
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-6005
Mailing Address - Country:US
Mailing Address - Phone:321-843-5851
Mailing Address - Fax:407-599-1691
Practice Address - Street 1:1600 BUDINGER AVE STE C
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-6005
Practice Address - Country:US
Practice Address - Phone:321-843-5851
Practice Address - Fax:407-599-1691
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2025-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3362363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL129300600Medicaid
E0615Medicare ID - Type Unspecified