Provider Demographics
NPI:1780914176
Name:GOMBOSH, MIRIAM (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:
Last Name:GOMBOSH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1246 CASTILE AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4744
Mailing Address - Country:US
Mailing Address - Phone:305-243-5267
Mailing Address - Fax:305-243-7991
Practice Address - Street 1:1475 NW 12TH AVE
Practice Address - Street 2:SUITE 3300 D8-4
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1002
Practice Address - Country:US
Practice Address - Phone:305-243-5267
Practice Address - Fax:305-243-7991
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9265462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily