Organization Name: | ANA L. GOMEZ, PSY.D. P.A. |
NPI Number: | 1013040583 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANA L GOMEZ (PRESIDENT) |
Mailing Address: | 202 Lookout Pl Suite 100 Maitland |
State: | FL US |
Postal Code: | 327514488 |
Phone Number: | 4079278154 |
Fax Number: | |
NPI Enumeration Date: | 03/14/2007 |
NPI Last Update Date: | 01/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PY6628 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |