Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | ME67905 | FL |
N | 207VG0400X | Gynecologist | ME67905 | FL |
NPI | 1033174644 |
---|---|
Provider Name | Dr. Emilio J Gomez-Madrazo |
First Address | South Miami, FL 33143-4860 |
Second Address | South Miami, FL 33143-4860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 23/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250913000 | (05) | FL |
BC538 | MEDICARE ID (01) | FL |
C77548 | (02) | FL |