NPIMap

Individual provider Active NPI

Carlos J. Gomez, PH.D.

  • Psychologist
  • Miami, FL
National Provider Identifier
1043438864
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY 6938 Issued in FL
Practice address
9240 Sunset Dr
Suite 206
Miami, FL 33173-3261
Phone
(305) 205-0943
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY 6938 FL Primary
Cognitive & Behavioral Psychologist 103TB0200X PY 6938 FL
Clinical Psychologist 103TC0700X PY 6938 FL
Counseling Psychologist 103TC1900X PY 6938 FL
Clinical Child & Adolescent Psychologist 103TC2200X PY 6938 FL
Family Psychologist 103TF0000X PY 6938 FL
Group Psychotherapy Psychologist 103TP2701X PY 6938 FL

Addresses

Primary practice location

9240 Sunset Dr
Suite 206
Miami, FL 33173-3261

Mailing address

9240 Sunset Dr
Suite 206
Miami, FL 33173-3261
Phone (305) 205-0943

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY 6938FLMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Logistics Therapy of Broward LLC Past Accepting new patients
Theracorp Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1043438864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9240 SUNSET DR",
            "address_2": "SUITE 206",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733261",
            "telephone_number": "305-205-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9240 SUNSET DR",
            "address_2": "SUITE 206",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733261",
            "telephone_number": "305-205-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "CARLOS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 6938",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "FL",
            "license": "PY 6938",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 6938",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY 6938",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY 6938",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "FL",
            "license": "PY 6938",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "FL",
            "license": "PY 6938",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.