Provider Demographics
NPI:1073193330
Name:GOMEZ ALEJO, SORANIA LYANET
Entity Type:Individual
Prefix:
First Name:SORANIA
Middle Name:LYANET
Last Name:GOMEZ ALEJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7121 NW 174TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-1192
Mailing Address - Country:US
Mailing Address - Phone:786-707-7873
Mailing Address - Fax:
Practice Address - Street 1:7121 NW 174TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-1192
Practice Address - Country:US
Practice Address - Phone:786-707-7873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information