Provider Demographics
NPI:1629089883
Name:GOMEZ, KAREN A (CRNA)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:A
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 W CANTON AVE APT B444
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-7507
Mailing Address - Country:US
Mailing Address - Phone:773-263-0023
Mailing Address - Fax:
Practice Address - Street 1:12040 GRAND JARDIN DR APT 204
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-9955
Practice Address - Country:US
Practice Address - Phone:773-263-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11028350367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK25507Medicare ID - Type Unspecified