Provider Demographics
NPI:1366316002
Name:GOMEZ GARCIA, YAMILY SR
Entity type:Individual
Prefix:
First Name:YAMILY
Middle Name:
Last Name:GOMEZ GARCIA
Suffix:SR
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11024 LIGHTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-5134
Mailing Address - Country:US
Mailing Address - Phone:678-855-4567
Mailing Address - Fax:
Practice Address - Street 1:11024 LIGHTWOOD ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-5134
Practice Address - Country:US
Practice Address - Phone:678-855-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-04
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11039903363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty