Doctor Name: | MS. AMY JO GOMES |
NPI Number: | 1144317595 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.P.T. |
License Number: | PT2879 |
Business Practice Address: | 405 S Seminole Ave Minneola, FL - 347155520 |
Business Phone Number: | 3523940212 |
Business Fax Number: | 3522416361 |
Mailing Address: | 15051 Green Valley Blvd, CLERMONT |
State: | FL |
Postal Code: | 347118547 |
Phone Number: | 3522420953 |
Fax Number: | |
NPI Enumeration Date: | 10/06/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | PT2879 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |