Gomez, Edwin Antonio

Gomez, Edwin Antonio is an sole proprietor health care provider with primary practice located at 1040 Weston Rd Suite 210, Weston FL 33326-1912. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Gomez, Edwin Antonio can be contacted via phone (954) 766-4702.

Contact Information

Primary practice address
1040 Weston Rd Suite 210 Weston FL 33326-1912
Phone: (954) 766-4702
Fax: (954) 766-4907
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME97741 Florida
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X ME97741 Florida

Profile Details

NPI number 1780775098
LBN Legal business name Gomez, Edwin Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 28th, 2006
Last updated Jan 13th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780775098 NPPES
Florida MEDICAID 001441900
Florida Other GM814A

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