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General NPI Number Information
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NPI Number | 1740420959
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Entity Type | Organization
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Legal Business Name | MICHAEL J GOMEZ MD PA
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Dates
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Enumeration Date | 02/27/2009
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Last Update Date | 02/27/2009
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Provider Practice Location Address
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Address Line | 8925 SW 148TH ST SUITE 110
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City | VILLAGE OF PALMETTO BAY
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State | FL
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Zip | 33176-8000
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Country | US
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Telephone | 305-742-7767
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Fax | 786-228-0423
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Provider Business Mailing Address
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Address Line | 8925 SW 148TH ST SUITE 110
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City | VILLAGE OF PALMETTO BAY
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State | FL
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Zip | 33176-8000
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Country | US
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Telephone | 305-742-7767
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Fax | 786-228-0423
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Authorized Official
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Title or Position | OWNER
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Name | MICHEL J GOMEZ
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Credential | MD
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Telephone | 305-742-7767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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