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NPI Code Detail

MEDICARE: JOSE MARIA GOMEZ M.D.

MEDICARE: JOSE MARIA 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
12084P0800XPsychiatry PhysicianME 37948FL

General Provider Information

NPI Number : 1811929532
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE MARIA GOMEZ M.D.
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 :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 07/09/2012

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