Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 228950 | MA |
NPI | 1013949544 |
---|---|
Provider Name | Nelson A Gomez |
First Address | Brandon, FL 33511-4936 |
Second Address | Brandon, FL 33511-4936 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 04/10/2012 |