Provider Demographics
NPI:1851392369
Name:GOMEZ, EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8350 RIVERWALK PARK BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-8759
Mailing Address - Country:US
Mailing Address - Phone:239-482-5399
Mailing Address - Fax:239-482-5153
Practice Address - Street 1:8350 RIVERWALK PARK BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-8759
Practice Address - Country:US
Practice Address - Phone:239-482-5399
Practice Address - Fax:239-482-5153
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0068661207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL200021661OtherRAILROAD MEDICARE
FL378107100Medicaid
FL27455ZMedicare PIN
FL200021661OtherRAILROAD MEDICARE
FL0425580001Medicare NSC