Individual
GUSTAVO GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 OPPORTUNITY WAY, LAGRANGE, OH 44050-9018
(440) 222-4160
(440) 355-4213
Mailing address
1957 COOPER FOSTER PARK RD, AMHERST, OH 44001-1207
(440) 989-3801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.128395
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0179466
—
OH
Enumeration date
04/10/2012
Last updated
11/29/2016
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