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NPI Code Detail

MEDICARE: FLORANGEL GOMEZ EDRALIN M.D.

MEDICARE: FLORANGEL GOMEZ EDRALIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianME65289FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093732919
Entity Type Code : Individual
Provider Name (Legal Business Name) : FLORANGEL GOMEZ EDRALIN M.D.
Provider Business Mailing Address
First Line : 6910 OLD WOLF BAY RD
Second Line :
City : PALATKA
State : FL
Zip : 32177-6800
Country : US
Telephone Number : 386-328-7337
Fax Number : 386-325-3742
Provider Business Practice Location Address
First Line : 6910 OLD WOLF BAY RD
Second Line :
City : PALATKA
State : FL
Zip : 32177-6800
Country : US
Telephone Number : 386-328-7337
Fax Number : 386-325-3742
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 07/01/2020

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