Healthcare Provider Details

I. General information

NPI: 1720164064
Provider Name (Legal Business Name): ANGELA A GOMEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2006
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 PONCE DE LEON BLVD SUITE 606
CORAL GABLES FL
33134-2049
US

IV. Provider business mailing address

747 PONCE DE LEON BLVD SUITE 606
CORAL GABLES FL
33134-2049
US

V. Phone/Fax

Practice location:
  • Phone: 305-444-7779
  • Fax: 305-444-7290
Mailing address:
  • Phone: 305-444-7779
  • Fax: 305-444-7290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberME82920
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: