Provider Demographics
NPI:1609075290
Name:GORTON, PATRICIA R (PA-C)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:R
Last Name:GORTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:702 GOODLETTE RD N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5628
Mailing Address - Country:US
Mailing Address - Phone:239-261-2255
Mailing Address - Fax:239-261-3194
Practice Address - Street 1:702 GOODLETTE RD N
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5628
Practice Address - Country:US
Practice Address - Phone:239-261-2255
Practice Address - Fax:239-261-3194
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA 2969363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant