MEDICARE: FERNANDO L. GOMEZ MD

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
1	207VE0102X	Reproductive Endocrinology Physician	ME78577	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1699705442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FERNANDO L. GOMEZ MD

Provider Business Mailing Address
First Line	:	7806 LAKE UNDERHILL RD
Second Line	:	SUITE 105
City	:	ORLANDO
State	:	FL
Zip	:	32822-8232
Country	:	US
Telephone Number	:	407-281-9229
Fax Number	:	407-207-7180

Provider Business Practice Location Address
First Line	:	7806 LAKE UNDERHILL RD
Second Line	:	SUITE 105
City	:	ORLANDO
State	:	FL
Zip	:	32822-8232
Country	:	US
Telephone Number	:	407-281-9229
Fax Number	:	407-207-7180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	03/10/2008

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