Individual
XIOMARA M GOMEZ HEREDIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1409 AVE PONCE DE LEON, SAN JUAN, PR 00907-4023
(787) 960-6818
(787) 725-4487
Mailing address
1409 AVE PONCE DE LEON, SAN JUAN, PR 00907-4023
(787) 960-6818
(787) 725-4487
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
12088
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12088
STATE LICENCE
PR
Enumeration date
05/23/2007
Last updated
07/08/2007
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