Organization
MARIO GOMEZ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO GOMEZ MD (PRESIDENT)
(786) 256-4174
Entity
Organization
Contact information
Practice address
925 NE 30TH TER, SUITE 300, HOMESTEAD, FL 33033-7613
(786) 256-4174
Mailing address
8775 SW 164 ST, PALMETTO BAY, FL 33157-3562
(786) 256-4174
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME102113
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001046400
—
FL
Enumeration date
04/05/2011
Last updated
04/05/2011
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