Provider Demographics
NPI:1972293132
Name:GOMEZ, ALEXANDRA (ARNP)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 4TH ST # 1065
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3763
Mailing Address - Country:US
Mailing Address - Phone:305-834-9797
Mailing Address - Fax:
Practice Address - Street 1:1200 4TH ST # 1065
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3763
Practice Address - Country:US
Practice Address - Phone:305-834-9797
Practice Address - Fax:305-517-6439
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11025975363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner