DR. GORDON J PENN O.D. NPI 1417960881

NPI Information

NPI: 1417960881
Provider Name: DR. GORDON J PENN, O.D.
Classification: Optometrist - 152WC0802X
Entity Type: Individual

Specialization: Corneal and Contact Management

PECOS Registration: Yes

Address:
8500 N WICKHAM RD
VIERA, FL
ZIP 32940
Phone: (321) 259-4393
Get Directions

DR. Gordon J Penn, O.D. is a corneal and contact management optometrist in Viera, FL. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. DR. Gordon J Penn, O.D. NPI is 1417960881. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8500 N WICKHAM RD
VIERA, FL
ZIP 32940-600
Phone: (321) 259-4393
Fax: (321) 242-6132

The NPI 1417960881 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 8/15/2006 and was last updated on 10/7/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	152WC0802X	Optometrist	Corneal and Contact Management	2710	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	20466	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA	MEDICARE #
2	U21130	MEDICARE UPIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »