Active NPI
Julio A Gomez de Mello
- Specialist
- Hialeah, FL
National Provider Identifier
1003169400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA-64739
- Practice address
- 928 W 67TH St
Hialeah, FL 33012-6467 - Phone
- (305) 965-6098
- NPI assigned
- Oct 23, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA-64739 | FL | Primary |
Addresses
Primary practice location
928 W 67TH St
Hialeah, FL 33012-6467
Mailing address
928 W 67TH St
Hialeah, FL 33012-6467
Phone (305) 965-6098
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA-64739 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350950400000",
"number": "1003169400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "928 W 67TH ST",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330126467",
"telephone_number": "305-965-6098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "928 W 67TH ST",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330126467",
"telephone_number": "305-965-6098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ DE MELLO",
"first_name": "JULIO",
"middle_name": "A",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-23",
"last_updated": "2012-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "FL",
"license": "MA-64739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.