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General NPI Number Information
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NPI Number | 1053460360
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Entity Type | Organization
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Legal Business Name | EDUARDO G GOMEZ MD PA
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 04/23/2013
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Provider Practice Location Address
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Address Line | 1840 W 49TH ST SUITE 607
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City | HIALEAH
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State | FL
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Zip | 33012-2942
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Country | US
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Telephone | 305-556-7416
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Fax | 305-824-0879
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Provider Business Mailing Address
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Address Line | 1840 W 49TH ST SUITE 607
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City | HIALEAH
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State | FL
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Zip | 33012-2942
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Country | US
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Telephone | 305-556-7416
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Fax | 305-824-0879
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDUARDO G GOMEZ
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Credential | MD PA
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Telephone | 305-556-7416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State | FL
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