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Provider Information for 1639762586

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

AMALIA GOMEZ CPT

Other Name:   AMALIA GOMEZ
Gender: FEMALE

Individual NPI: 1639762586

Calendar   Last Updated:  2021-02-11
  Certification Date:  2021-02-03

Details

Name Value
NPI 1639762586
Enumeration Date 2021-02-11
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 535 CLOUDCROFT DR
DELTONA, FL 32738-9279
United States

Phone: 074-777-1711 | Fax:
View Map External Link
Primary Practice Address 535 CLOUDCROFT DR
DELTONA, FL 32738-9279
United States

Phone: 407-777-1711 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other URL DELTONA Health Information Exchange (HIE) DELTONA 535 CLOUDCROFT DR
DELTONA, FL 32738-9279
United States
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 193400000X MULTIPLE SINGLE SPECIALTY GROUP
246RP1900X - Technician, Pathology Phlebotomy
FL