Provider Demographics
NPI:1730503673
Name:GOMEZ, NANCY (HHA)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10825 WINDSOR WALK DR APT 302
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7320
Mailing Address - Country:US
Mailing Address - Phone:321-637-9349
Mailing Address - Fax:
Practice Address - Street 1:10825 WINDSOR WALK DR APT 302
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7320
Practice Address - Country:US
Practice Address - Phone:321-697-2631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3987374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide