MEDICARE: DR. MAURICIO 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	207R00000X	Internal Medicine Physician	ME155875	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	:	1912467382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAURICIO GOMEZ MD

Provider Business Mailing Address
First Line	:	2329 MERRIWEATHER WAY
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6430
Country	:	US
Telephone Number	:	954-224-0175
Fax Number	:

Provider Business Practice Location Address
First Line	:	2326 S CONGRESS AVE STE 1C
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-7652
Country	:	US
Telephone Number	:	561-433-5577
Fax Number	:	561-275-2696

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

Provider Enumeration Date	:	03/21/2019
Last Update Date	:	05/26/2026

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