Individual
MS. SUIRA GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9785 CROSSHILL BLVD # 108, JACKSONVILLE, FL 32222-5823
(904) 772-6522
Mailing address
9632 GROVE HILL LN, JACKSONVILLE, FL 32222-1556
(954) 512-0826
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA48277
FL
225700000X
Massage Therapist
48277
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA48277
MA 48277
FL
Enumeration date
04/17/2022
Last updated
02/21/2023
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