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General NPI Number Information
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NPI Number | 1497065296
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Entity Type | Individual
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Provider Name | ERNEST ROBERT GOMMEL JR. P.T.
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Gender | Male
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 06/29/2020
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Provider Practice Location Address
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Address Line | 5968 CLARK CENTER AVE
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City | SARASOTA
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State | FL
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Zip | 34238-2715
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Country | US
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Telephone | 941-922-8200
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Fax | 941-343-9402
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Provider Business Mailing Address
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Address Line | 6601 TIDWELL ST
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City | NORTH PORT
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State | FL
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Zip | 34291-4103
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Country | US
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Telephone | 941-661-8632
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Fax | 941-343-9402
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT14990
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License Number State | FL
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