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NPI Code Detail

MEDICARE: NOLEYS GOMEZ

MEDICARE: NOLEYS GOMEZ
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
1222Q00000XDevelopmental Therapist

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 : 1841834736
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOLEYS GOMEZ
Provider Business Mailing Address
First Line : 4097 SUSSEX AVE
Second Line :
City : LAKE WORTH
State : FL
Zip : 33461-1719
Country : US
Telephone Number : 786-537-5904
Fax Number : 561-584-5033
Provider Business Practice Location Address
First Line : 4097 SUSSEX AVE
Second Line :
City : LAKE WORTH
State : FL
Zip : 33461-1719
Country : US
Telephone Number : 786-537-5904
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2019
Last Update Date : 04/14/2022

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Directions to “ NOLEYS GOMEZ ” Practice Location

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