Provider Demographics
NPI:1992834055
Name:GOMEZ, YOLANDA (MD)
Entity type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CALLE NOGAL
Mailing Address - Street 2:LADERAS DE SAN JUAN
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9309
Mailing Address - Country:US
Mailing Address - Phone:787-438-7679
Mailing Address - Fax:787-758-0760
Practice Address - Street 1:3 CALLE NOGAL
Practice Address - Street 2:LADERAS DE SAN JUAN
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9309
Practice Address - Country:US
Practice Address - Phone:787-438-7679
Practice Address - Fax:787-758-0760
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9151208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics