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General NPI Number Information
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NPI Number | 1417298787
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Entity Type | Organization
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Legal Business Name | GERARDO GARCIA GOMEZ MD PA
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Dates
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Enumeration Date | 03/11/2013
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Last Update Date | 03/11/2013
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Provider Practice Location Address
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Address Line | 330 SW 27TH AVE SUITE 401
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City | MIAMI
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State | FL
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Zip | 33135-2961
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Country | US
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Telephone | 305-456-2966
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Fax | 786-953-8951
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Provider Business Mailing Address
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Address Line | 330 SW 27TH AVE SUITE 401
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City | MIAMI
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State | FL
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Zip | 33135-2961
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Country | US
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Telephone | 305-456-2966
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Fax | 786-953-8951
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | GERARDO GARCIA GOMEZ
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Credential | MD
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Telephone | 915-487-6312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME110169
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License Number State | FL
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