Provider Demographics
NPI:1447236294
Name:GOMEZ, ANTONIO MERCED JR (HS1)
Entity Type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:MERCED
Last Name:GOMEZ
Suffix:JR
Gender:M
Credentials:HS1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COMDT (CG-1122) USCG
Mailing Address - Street 2:2100 2ND ST SW, SUITE 5314
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:616-850-2520
Mailing Address - Fax:616-850-2521
Practice Address - Street 1:COMDT (CG-1122) USCG
Practice Address - Street 2:2100 2ND ST SW, SUITE 5314
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20593-0001
Practice Address - Country:US
Practice Address - Phone:616-850-2520
Practice Address - Fax:616-850-2521
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other