Provider Demographics
NPI:1962766527
Name:GOMEZ, LUZ B (APRN)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:B
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:1025 MILITARY TRL
Mailing Address - Street 2:SUITE #109
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7040
Mailing Address - Country:US
Mailing Address - Phone:561-741-0000
Mailing Address - Fax:561-745-4212
Practice Address - Street 1:1025 MILITARY TRL
Practice Address - Street 2:SUITE #109
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7040
Practice Address - Country:US
Practice Address - Phone:561-741-0000
Practice Address - Fax:561-745-4212
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2018-10-29
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN9242922363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007221200Medicaid