Individual provider · Type 1 NPI
Dominique S. Gordon, FNP-C, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Palm Bay, FL
NPI number
1982204178
Active
Practice location
160 Malabar Rd SW Ste 112
Palm Bay, FL 32907-2912
Fax (321) 617-5863
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11014427 (FL) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | APRN11014427 (FL) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1982204178
Dominique S. Gordon, FNP-C, PMHNP-BC's National Provider Identifier is 1982204178, issued on Oct 28, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Palm Bay, FL. The record was last updated on Sep 8, 2026.