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NPI Code Detail

MEDICARE: GOMEZCARE INC

MEDICARE: GOMEZCARE INC
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
12084P0805XGeriatric Psychiatry PhysicianME 37948FL

General Provider Information

NPI Number : 1750553160
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOMEZCARE INC
Provider Business Mailing Address
First Line : 4217 BAYMEADOWS RD
Second Line : SUITE#3
City : JACKSONVILLE
State : FL
Zip : 32217-4676
Country : US
Telephone Number : 904-332-7431
Fax Number : 904-332-7408
Provider Business Practice Location Address
First Line : 4217 BAYMEADOWS RD
Second Line : SUITE #3
City : JACKSONVILLE
State : FL
Zip : 32217-4676
Country : US
Telephone Number : 904-332-7431
Fax Number : 904-332-7408
Authorized Official
Title or Position : PRESIDENT-OWNER
Name : JOSE MARIA GOMEZ
Credential : M.D.
Telephone Number : 904-332-7431
Provider Enumeration Date : 03/25/2008
Last Update Date : 08/30/2010

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Directions to “GOMEZCARE INC ” Practice Location

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