Provider Demographics
NPI:1841217379
Name:GOMEZ-ABREU, CARMEN (CSW)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:GOMEZ-ABREU
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1738 SW 57TH AVE # A317
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2137
Mailing Address - Country:US
Mailing Address - Phone:305-342-4891
Mailing Address - Fax:
Practice Address - Street 1:9350 SUNSET DR STE 151
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3286
Practice Address - Country:US
Practice Address - Phone:786-548-1022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW5341101YA0400X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU0475YMedicare PIN