MEDICARE: ALFREDO F. GOMEZ CRNA

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	367500000X	Certified Registered Nurse Anesthetist	ARNP 2515132	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	430050723	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G2239	OTHER	FL	BCBS OF FLORIDA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437139292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFREDO F. GOMEZ CRNA

Provider Business Mailing Address
First Line	:	1986 NE 35TH CT
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33308-6255
Country	:	US
Telephone Number	:	954-253-0932
Fax Number	:	954-253-0932

Provider Business Practice Location Address
First Line	:	1725 N UNIVERSITY DR
Second Line	:	2ND FLOOR
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6089
Country	:	US
Telephone Number	:	954-227-7760
Fax Number	:	954-227-9975

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	04/19/2017

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Directions to “ ALFREDO F. GOMEZ CRNA” Practice Location

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