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Individual

GREGORY M LOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
842 SUNSET LAKE BLVD, SUITE 403, BLDG. B, VENICE, FL 34292-7551
(941) 485-3351
(941) 485-7677
Mailing address
2234 COLONIAL BLVD, ATTN: MANAGED CARE DEPARTMENT, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
G77161
CA
208800000X
Urology Physician
Primary
ME101239
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05D0617976
CLIA ID
CA
01
1193368
WELLCARE
FL
01
1632316323
UNIVERSAL HEALTHCARE
FL
01
340007664
RAILROAD MEDICARE
CA
01
344542
AVMED
FL
01
CP5241
RAILROAD MEDICARE GROUP
CA
01
P00700437
R.R. MEDICARE
FL
01
QMP000005225583
MOLINA HEALTHCARE
FL
05
ZZZ78528Z
CA
Enumeration date
09/26/2006
Last updated
09/18/2017
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