Healthcare Provider Details

I. General information

NPI: 1457469207
Provider Name (Legal Business Name): MARIA ARMINDA GOMEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PUERTO RICO MEDICAL CENTER BO. MONACILLO HOSPITAL SAN JUAN
SAN JUAN PR
00926
US

IV. Provider business mailing address

COSTA RICA ST # 185 COND. TEIDE APT. 902
SAN JUAN PR
00917-2535
US

V. Phone/Fax

Practice location:
  • Phone: 787-765-0521
  • Fax:
Mailing address:
  • Phone: 787-593-6861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number5341
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: