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Provider Information for 1205344322

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

ALEJANDRO A GOMEZ

Gender: MALE

Individual NPI: 1205344322

Calendar   Last Updated:  2018-01-11
  Certification Date: 

Details

Name Value
NPI 1205344322
Enumeration Date 2018-01-11
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 1421 NW 41ST ST
MIAMI, FL 33142-4860
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 1421 NW 41ST ST
MIAMI, FL 33142-4860
United States

Phone: 786-616-4510 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 106S00000X - Behavior Technician