Individual
MARY JOY L GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
400 N MILLS AVE, ORLANDO, FL 32803-5722
(407) 581-9180
(407) 926-9173
Mailing address
PO BOX 4918, ORLANDO, FL 32802-4918
(407) 581-9180
(407) 926-9173
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP1093052
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0347876 00
—
FL
01
—
430048782
RAILROAD MEDICARE
—
01
—
G1703
BCBS
FL
01
—
XXX-XX-1936
TRICARE (SOUTH REGION)
—
Enumeration date
07/21/2006
Last updated
01/10/2013
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