Healthcare Provider Details

I. General information

NPI: 1124526561
Provider Name (Legal Business Name): HANY GOMEZ APRN, PMHNP-BC,FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2018
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 S HOMESTEAD BLVD
HOMESTEAD FL
33030-7309
US

IV. Provider business mailing address

17900 SW 143RD CT
MIAMI FL
33177-7663
US

V. Phone/Fax

Practice location:
  • Phone: 786-800-5343
  • Fax:
Mailing address:
  • Phone: 305-979-1395
  • Fax: 786-957-8214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9364713
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9364713
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: