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General NPI Number Information
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NPI Number | 1053751198
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Entity Type | Individual
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Provider Name | EVELYN GOMEZ-GARCIA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 355 AVE FONT MARTELO
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City | HUMACAO
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State | PR
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Zip | 00791-3249
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Country | US
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Telephone | 787-852-0768
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 671
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City | SAN LORENZO
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State | PR
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Zip | 00754-0671
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Country | US
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Telephone | 787-479-4236
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 19552
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License Number State | PR
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