MEDICARE: JOSE A. ALEMAN-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
1	207RC0000X	Cardiovascular Disease Physician	ME65880	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740275916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE A. ALEMAN-GOMEZ M.D.

Provider Business Mailing Address
First Line	:	100 ARRICOLA AVE
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32080-4515
Country	:	US
Telephone Number	:	904-825-4368
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 NW 16TH AVE
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32601-4012
Country	:	US
Telephone Number	:	352-727-4641
Fax Number	:

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	03/06/2023

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