Provider Demographics
NPI:1447219118
Name:GOMEZ NUNEZ, GERARDINA MARIA (DMD)
Entity Type:Individual
Prefix:MRS
First Name:GERARDINA
Middle Name:MARIA
Last Name:GOMEZ NUNEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE 28 AS9 BAIROA
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-360-3055
Mailing Address - Fax:
Practice Address - Street 1:GK36 AVE ROBERTO SANCHEZ VILELLA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2657
Practice Address - Country:US
Practice Address - Phone:787-276-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice