Individual
DIANA C. GOMEZ MANJARRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-0225
(352) 273-8737
Mailing address
PO BOX 100225, GAINESVILLE, FL 32610-0225
(352) 273-8737
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
53146020
WI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME135021
FL
207RP1001X
Pulmonary Disease Physician
0101257479
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023901600
—
FL
Enumeration date
06/30/2009
Last updated
04/14/2018
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