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General NPI Number Information
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NPI Number | 1336777069
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Entity Type | Individual
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Provider Name | MARIA A GOMEZ PHD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 03/30/2020
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Provider Practice Location Address
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Address Line | 1809 SANTA MARTA STREET URB. EL PILAR
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-568-2224
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Fax | 787-756-0144
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Provider Business Mailing Address
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Address Line | 1809 SANTA MARTA STREET URB. EL PILAR
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-568-2224
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Fax | 787-756-0144
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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 | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | 1392
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License Number State | PR
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