Provider Demographics
NPI:1225097801
Name:GOMEZ, ISABEL CRISTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:ISABEL
Middle Name:CRISTINA
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 W 49TH ST
Mailing Address - Street 2:SUITE # 517
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2942
Mailing Address - Country:US
Mailing Address - Phone:305-894-1164
Mailing Address - Fax:786-360-3867
Practice Address - Street 1:1840 W 49TH ST
Practice Address - Street 2:SUITE # 517
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2942
Practice Address - Country:US
Practice Address - Phone:305-894-1164
Practice Address - Fax:786-360-3867
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044895208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58991Medicare UPIN