Provider Demographics
NPI:1013949544
Name:GOMEZ, NELSON A (MD)
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:A
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 1:910 OAKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4936
Mailing Address - Country:US
Mailing Address - Phone:813-681-4413
Mailing Address - Fax:813-684-7299
Practice Address - Street 1:910 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4936
Practice Address - Country:US
Practice Address - Phone:813-681-4413
Practice Address - Fax:813-684-7299
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228950207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine