Individual
BRUNEL TERESA GOMEZ DE TAVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14405 ARBOR GREEN TRL, LAKEWOOD RANCH, FL 34202-8409
(941) 917-7080
(941) 917-7085
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME130101
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376537700
—
FL
Enumeration date
04/30/2013
Last updated
07/12/2019
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