Individual
MRS. MISTY GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1465 OAKFIELD DR, BRANDON, FL 33511-4854
(813) 716-5594
Mailing address
4406 MOORES LAKE RD, DOVER, FL 33527-4023
(813) 716-5594
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA18604
FL
Other
Enumeration date
01/23/2012
Last updated
01/23/2012
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