Provider Demographics
NPI:1093405078
Name:GOMEZ, MARIA ISABELLA (DPT, CSCS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ISABELLA
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7812 REGAL HERON CIR APT 204
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-5952
Mailing Address - Country:US
Mailing Address - Phone:239-537-6400
Mailing Address - Fax:
Practice Address - Street 1:661 GOODLETTE RD STE 101
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5609
Practice Address - Country:US
Practice Address - Phone:239-261-4592
Practice Address - Fax:239-261-0716
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT99999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist