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NPI Code Detail

MEDICARE: GENESIS MARIE GOMEZ

MEDICARE: GENESIS MARIE 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1861327694
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENESIS MARIE GOMEZ
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number : 844-244-1818
Fax Number :
Provider Business Practice Location Address
First Line : 5020 GUNN HWY STE 250
Second Line :
City : TAMPA
State : FL
Zip : 33624-6361
Country : US
Telephone Number : 813-733-8572
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “ GENESIS MARIE GOMEZ ” Practice Location

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