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General NPI Number Information
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NPI Number | 1942001995
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Entity Type | Organization
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Legal Business Name | GOMEZ MAXILLOFACIAL PA
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 201 N LAKEMONT AVE STE 2200
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City | WINTER PARK
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State | FL
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Zip | 32792-3208
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Country | US
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Telephone | 407-629-0075
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Fax | 407-629-0027
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Provider Business Mailing Address
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Address Line | 201 N LAKEMONT AVE STE 2200
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City | WINTER PARK
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State | FL
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Zip | 32792-3208
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Country | US
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Telephone | 407-629-0075
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Fax | 407-629-0027
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Authorized Official
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Title or Position | OWNER/CEO
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Name | FRANKIE GOMEZ
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Credential | DMD
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Telephone | 407-629-0075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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