Gomez, Guillermo
Gomez, Guillermo is an sole proprietor health care provider with primary practice located at 4146 Jonesboro Rd , Forest Park GA 30297-1038. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Gomez, Guillermo can be contacted via phone (404) 361-2469.Contact Information
Primary practice address
4146 Jonesboro Rd
Forest Park GA 30297-1038
Phone: (404) 361-2469
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN126015 NP | Georgia |
Profile Details
| NPI number | 1972508752 |
|---|---|
| LBN Legal business name | Gomez, Guillermo |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 17th, 2005 |
| Last updated | Jun 26th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972508752 | NPPES |
| Georgia | MEDICAID | 810457223B |
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