Healthcare Provider Details

I. General information

NPI: 1619891116
Provider Name (Legal Business Name): BEATRIZ GOMEZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 BRUNSON DR
CORAL GABLES FL
33146-2412
US

IV. Provider business mailing address

555 WASHINGTON AVE STE 260
MIAMI BEACH FL
33139-6643
US

V. Phone/Fax

Practice location:
  • Phone: 305-284-3666
  • Fax:
Mailing address:
  • Phone: 786-387-1248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11050880
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: