Individual
MR. EDGAR ENRIQUE GOMEZ SR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
BASIC X RAY TECH
Contact information
Practice address
711 NW 23RD AVE, 204, MIAMI, FL 33125-3298
(305) 541-2888
(305) 541-2879
Mailing address
9220 FONTAINEBLEAU BLVD, 503, MIAMI, FL 33172-4237
(786) 514-2855
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
48679
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48679
XRAY MACHINE OPERATOR
FL
Enumeration date
06/08/2006
Last updated
07/08/2007
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