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General NPI Number Information
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NPI Number | 1043531304
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Entity Type | Organization
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Legal Business Name | EDDUNIO GOMEZ M.D. P.A.
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 17 NE 9TH CT
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City | HOMESTEAD
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State | FL
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Zip | 33030-4611
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Country | US
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Telephone | 305-245-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 17 NE 9TH CT
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City | HOMESTEAD
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State | FL
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Zip | 33030-4611
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Country | US
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Telephone | 305-245-5050
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/SOLE OWNER
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Name | DR. EDDUNIO GOMEZ
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Credential | M.D.
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Telephone | 305-245-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME34559
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License Number State | FL
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