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General NPI Number Information
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NPI Number | 1992945257
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Entity Type | Individual
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Provider Name | LILIANA GOMEZ-MEDLEY MD
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Gender | Female
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Dates
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Enumeration Date | 02/26/2009
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 2345 BENT WAY
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City | LONGMONT
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State | CO
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Zip | 80503-7614
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Country | US
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Telephone | 303-338-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 10350 E DAKOTA AVE
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City | DENVER
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State | CO
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Zip | 80247-1314
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0073927
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME155284
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License Number State | FL
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