# MARIO GOMEZ MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538458153
- **Authorized official:** MARIO GOMEZ MD (PRESIDENT)
- **Authorized official phone:** (786) 256-4174

## Contact information

- **Practice address:** 925 NE 30TH TER, SUITE 300, HOMESTEAD, FL 33033-7613
- **Practice address phone:** (786) 256-4174
- **Mailing address:** 8775 SW 164 ST, PALMETTO BAY, FL 33157-3562
- **Mailing address phone:** (786) 256-4174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME102113 | FL | Yes |

## Other

- **Enumeration date:** 04/05/2011
- **Last updated:** 04/05/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001046400 | — | FL |