MEDICARE: JOHN 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	207L00000X	Anesthesiology Physician	ME38858	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	:	1952318610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN GOMEZ MD

Provider Business Mailing Address
First Line	:	12037 NW 50TH DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3522
Country	:	US
Telephone Number	:	954-240-4627
Fax Number	:

Provider Business Practice Location Address
First Line	:	8130 ROYAL PALM BLVD
Second Line	:	SUITE #100
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-5703
Country	:	US
Telephone Number	:	954-341-3538
Fax Number	:

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	09/10/2020

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Directions to “ JOHN GOMEZ MD” Practice Location

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