Provider Demographics
NPI:1003027277
Name:GOMEZ, MARIA CARIDAD (RD)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:CARIDAD
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 HILLCREST DR APT 406
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-7882
Mailing Address - Country:US
Mailing Address - Phone:305-979-6738
Mailing Address - Fax:
Practice Address - Street 1:950 HILLCREST DR APT 406
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-7882
Practice Address - Country:US
Practice Address - Phone:305-979-6738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 113133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered