Individual
JACQUELINE GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2736 HOLLYWOOD BLVD, HOLLYWOOD, FL 33020-4808
(954) 603-1881
Mailing address
2736 HOLLYWOOD BLVD, HOLLYWOOD, FL 33020-4808
(954) 603-1881
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16226
FL
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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