Individual
AMADA LIGIA GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1989 CITRINE WAY, SANTA ROSA, CA 95404-7012
(786) 385-4492
Mailing address
11750 NE 16TH AVE APT 209, NORTH MIAMI, FL 33161-6929
(786) 385-4492
(305) 673-4840
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11006625
FL
363LF0000X
Family Nurse Practitioner
95015461
CA
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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