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NPI Code Detail

MEDICARE: GERARDO J DIEGUEZ GOMEZ M.D.

MEDICARE: GERARDO J DIEGUEZ GOMEZ M.D.
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
1207R00000XInternal Medicine PhysicianME89001FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689677262
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERARDO J DIEGUEZ GOMEZ M.D.
Provider Business Mailing Address
First Line : PO BOX 2699
Second Line :
City : PENSACOLA
State : FL
Zip : 32513-2699
Country : US
Telephone Number : 850-475-4500
Fax Number : 850-650-2787
Provider Business Practice Location Address
First Line : 36500 EMERALD COAST PKWY
Second Line :
City : DESTIN
State : FL
Zip : 32541-4713
Country : US
Telephone Number : 850-837-0032
Fax Number : 850-650-2787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 06/25/2015

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