Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | ME94251 | FL |
NPI | 1194843722 |
---|---|
Provider Name | Dr. Michael J Gomez |
First Address | Miami, FL 33155 |
Second Address | Village Of Palmetto Bay, FL 33176-8000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 24/03/2009 |