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General NPI Number Information
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NPI Number | 1952318610
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Entity Type | Individual
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Provider Name | JOHN GOMEZ MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | 8130 ROYAL PALM BLVD SUITE #100
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-5703
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Country | US
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Telephone | 954-341-3538
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Fax |
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Provider Business Mailing Address
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Address Line | 12037 NW 50TH DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-3522
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Country | US
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Telephone | 954-240-4627
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME38858
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License Number State | FL
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