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NPI Code Detail

MEDICARE: IDELET GUTIERREZ GOMEZ

MEDICARE: IDELET GUTIERREZ 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
1235Z00000XSpeech-Language Pathologist13142FL

General Provider Information

NPI Number : 1629783527
Entity Type Code : Individual
Provider Name (Legal Business Name) : IDELET GUTIERREZ GOMEZ
Provider Business Mailing Address
First Line : 1263 NW 87TH AVE
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33071-7176
Country : US
Telephone Number : 786-578-4183
Fax Number :
Provider Business Practice Location Address
First Line : 1263 NW 87TH AVE
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33071-7176
Country : US
Telephone Number : 786-578-4183
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2023
Last Update Date : 01/05/2026

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Directions to “ IDELET GUTIERREZ GOMEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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