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NPI Code Detail

MEDICARE: MR. LAWRENCE EUGENE GOMES II DIRECT CARE WORKER

MEDICARE:  MR. LAWRENCE EUGENE GOMES II DIRECT CARE WORKER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747A0650XAttendant Care ProviderNAAZ

General Provider Information

NPI Number : 1093428492
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LAWRENCE EUGENE GOMES II DIRECT CARE WORKER
Provider Business Mailing Address
First Line : 10933 W COTTONWOOD LN
Second Line :
City : AVONDALE
State : AZ
Zip : 85392-4322
Country : US
Telephone Number : 602-616-0723
Fax Number :
Provider Business Practice Location Address
First Line : 10933 W COTTONWOOD LN
Second Line :
City : AVONDALE
State : AZ
Zip : 85392-4322
Country : US
Telephone Number : 602-616-0723
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2022
Last Update Date : 12/12/2025

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Directions to “ MR. LAWRENCE EUGENE GOMES II DIRECT CARE WORKER” Practice Location

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