Healthcare Provider Details

I. General information

NPI: 1245928647
Provider Name (Legal Business Name): KARINA ANGELICA GOMEZ RODRIGUEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST, BRONX, NY 10451
NEW YORK NY
10451
US

IV. Provider business mailing address

234 E 149TH ST, BRONX, NY 10451
NEW YORK NY
10451
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5030
  • Fax:
Mailing address:
  • Phone: 718-579-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number208619
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: