Provider Demographics
NPI:1194728592
Name:GOMEZ, FLORENCIO ABASOLO (MD)
Entity type:Individual
Prefix:MR
First Name:FLORENCIO
Middle Name:ABASOLO
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:360 E 72ND ST
Mailing Address - Street 2:APT C2602
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4767
Mailing Address - Country:US
Mailing Address - Phone:212-517-4292
Mailing Address - Fax:212-472-0511
Practice Address - Street 1:2000 N VILLAGE AVE
Practice Address - Street 2:STE 205
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1001
Practice Address - Country:US
Practice Address - Phone:516-593-7227
Practice Address - Fax:516-593-1197
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY113433207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A63756Medicare UPIN
679801Medicare ID - Type Unspecified