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General NPI Number Information
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NPI Number | 1679805998
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Entity Type | Organization
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Legal Business Name | ANGELA GOMEZ MD PA
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 05/01/2013
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Provider Practice Location Address
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Address Line | 747 PONCE DE LEON BLVD SUITE 606
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City | CORAL GABLES
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State | FL
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Zip | 33134-2074
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Country | US
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Telephone | 305-444-7779
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Fax | 305-444-7290
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Provider Business Mailing Address
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Address Line | 747 PONCE DE LEON BLVD SUITE 606
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City | CORAL GABLES
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State | FL
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Zip | 33134-2074
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Country | US
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Telephone | 305-444-7779
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Fax | 305-444-7290
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANGELA A GOMEZ
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Credential | MD
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Telephone | 305-444-7779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME82920
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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