Individual
MARIAISYS GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
15255 MAX LEGGETT PKWY STE 4000, JACKSONVILLE, FL 32218-7277
(904) 383-1540
(904) 383-1413
Mailing address
15255 MAX LEGGETT PKWY STE 4000, JACKSONVILLE, FL 32218-7277
(904) 383-1540
(904) 383-1413
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN11004148
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104567600
—
FL
Enumeration date
10/10/2019
Last updated
03/31/2023
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