Provider Demographics
NPI:1639951700
Name:GOMEZ-ARCHEVAL, ANDREA NICOLE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:NICOLE
Last Name:GOMEZ-ARCHEVAL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4542 ESTATES CIR
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-7054
Mailing Address - Country:US
Mailing Address - Phone:561-714-0157
Mailing Address - Fax:
Practice Address - Street 1:5691 SE CROOKED OAK AVE
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-8319
Practice Address - Country:US
Practice Address - Phone:772-600-8159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor