Individual
LOREN EBRADA GOMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1430 MASON AVE, DAYTONA BEACH, FL 32117-4551
(386) 274-2000
(386) 274-2009
Mailing address
1690 DUNLAWTON AVE, PORT ORANGE, FL 32127-8979
(386) 271-2273
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
11011081
FL
363LP2300X
Primary Care Nurse Practitioner
F12200547
FL
Other
Enumeration date
08/05/2021
Last updated
11/20/2024
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