Healthcare Provider Details

I. General information

NPI: 1427715697
Provider Name (Legal Business Name): CARLOS ANDRES GOMEZ DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2021
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S ORLANDO AVE STE 310
WINTER PARK FL
32789-5543
US

IV. Provider business mailing address

681 ADDISON LONGWOOD TER APT 481
LONGWOOD FL
32750-5621
US

V. Phone/Fax

Practice location:
  • Phone: 689-350-9170
  • Fax:
Mailing address:
  • Phone: 407-350-7599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH13787
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: