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NPI Code Detail

MEDICARE: ROBERT S GOMEZ

MEDICARE: ROBERT S GOMEZ
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCAPRE.195124OH

General Provider Information

NPI Number : 1598645442
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT S GOMEZ
Provider Business Mailing Address
First Line : 8444 N 90TH ST STE 100
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-4437
Country : US
Telephone Number : 602-248-8886
Fax Number : 602-854-0504
Provider Business Practice Location Address
First Line : 42 E CRESCENTVILLE RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45246-1302
Country : US
Telephone Number : 513-671-7117
Fax Number : 513-671-7110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2025
Last Update Date : 03/20/2026

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