Provider Demographics
NPI:1336802537
Name:RODRIGUEZ GOMEZ, MONICA MARIA (APRN)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:MARIA
Last Name:RODRIGUEZ GOMEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 SW 92ND ST STE 204A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7377
Mailing Address - Country:US
Mailing Address - Phone:305-436-9933
Mailing Address - Fax:305-436-9944
Practice Address - Street 1:8525 SW 92ND ST STE D15
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7378
Practice Address - Country:US
Practice Address - Phone:305-912-9343
Practice Address - Fax:305-912-7701
Is Sole Proprietor?:No
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11015014363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11015014OtherLICENSE