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General NPI Number Information
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NPI Number | 1992048243
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Entity Type | Individual
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Provider Name | ROBERTO MATTHEW GOMEZ PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2013
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 25 OTERO RD
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City | LOS LUNAS
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State | NM
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Zip | 87031-5707
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Country | US
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Telephone | 719-502-0740
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Fax |
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Provider Business Mailing Address
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Address Line | 100 CARSON DR SE UNIT 1601
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City | LOS LUNAS
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State | NM
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Zip | 87031-3560
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Country | US
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Telephone | 719-502-0740
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP00007155
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License Number State | NM
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