MEDICARE: OLGA LUCIA GOMEZ

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	225700000X	Massage Therapist	MA104706	FL

General Provider Information

NPI Number	:	1427803246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLGA LUCIA GOMEZ

Provider Business Mailing Address
First Line	:	650 WEST AVE
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-5524
Country	:	US
Telephone Number	:	786-771-3805
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 WEST AVE
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-5524
Country	:	US
Telephone Number	:	786-771-3805
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2024
Last Update Date	:	04/23/2024

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Directions to “ OLGA LUCIA GOMEZ ” Practice Location

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