Provider Demographics
NPI:1750987228
Name:GOMEZ CABRERA, CLARA GISELA (APRN FHP)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:GISELA
Last Name:GOMEZ CABRERA
Suffix:
Gender:F
Credentials:APRN FHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8494 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4153
Mailing Address - Country:US
Mailing Address - Phone:305-266-7710
Mailing Address - Fax:
Practice Address - Street 1:8494 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4153
Practice Address - Country:US
Practice Address - Phone:305-266-7710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9491687363L00000X
FLAPRN11010097363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner