Individual
VIVIANA PAZ GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2020 59TH ST W, BRADENTON, FL 34209-4604
(941) 798-6513
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
ME151343
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111582300
—
FL
01
—
HA0W3
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/23/2018
Last updated
09/17/2021
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