Organization
INTEGRATED MIND MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MENCIA GOMEZ (MD)
(754) 210-5359
Entity
Organization
Contact information
Practice address
1946 TYLER ST, SUITE 14, HOLLYWOOD, FL 33020-4517
(754) 210-5359
(754) 210-5363
Mailing address
1946 TYLER ST, SUITE 14, HOLLYWOOD, FL 33020-4517
(754) 210-5359
(754) 210-5363
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME121955
FL
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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