MEDICARE: GOMEZ CHIROPRACTIC

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
1	111NR0400X	Rehabilitation Chiropractor

General Provider Information

NPI Number	:	1356018394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOMEZ CHIROPRACTIC

Provider Business Mailing Address
First Line	:	13911 N DALE MABRY HWY STE 107
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2414
Country	:	US
Telephone Number	:	813-915-5347
Fax Number	:	813-252-3412

Provider Business Practice Location Address
First Line	:	13911 N DALE MABRY HWY STE 107
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2414
Country	:	US
Telephone Number	:	813-915-5347
Fax Number	:	813-252-3412

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GIANELLA GOMEZ
Credential	:	D.C.
Telephone Number	:	813-915-5347

Provider Enumeration Date	:	08/26/2021
Last Update Date	:	08/26/2021

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Directions to “GOMEZ CHIROPRACTIC ” Practice Location

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