Provider Demographics
NPI:1457390486
Name:GOMEZ, RENE J (MD)
Entity type:Individual
Prefix:DR
First Name:RENE
Middle Name:J
Last Name:GOMEZ
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8950 SW 74TH CT
Mailing Address - Street 2:STE 1404
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3173
Mailing Address - Country:US
Mailing Address - Phone:305-670-8165
Mailing Address - Fax:305-670-8164
Practice Address - Street 1:7400 N KENDALL DR
Practice Address - Street 2:SUITE 511
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7706
Practice Address - Country:US
Practice Address - Phone:305-670-8165
Practice Address - Fax:305-670-8164
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2017-03-14
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Provider Licenses
StateLicense IDTaxonomies
FLME20305207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL054946100Medicaid
FL91776OtherMEDICARE PTAN
FLD79884Medicare UPIN