Individual provider Active NPI

Jose Ernesto Martinez Gomez

  • Radiography Radiologic Technologist
  • Port Charlotte, FL
National Provider Identifier
1245041565
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
License
583480 Issued in FL
Practice address
1226 Stamford St
Port Charlotte, FL 33952-2818
Phone
(818) 669-3091
NPI assigned
Jan 16, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic Technologist 2471C3402X 583480 FL Primary

Addresses

Primary practice location

1226 Stamford St
Port Charlotte, FL 33952-2818

Mailing address

1226 Stamford St
Port Charlotte, FL 33952-2818
Phone (818) 669-3091

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

LicenseStateTypeSpecialty
583480FLMDRadiography Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1245041565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 STAMFORD ST",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339522818",
            "telephone_number": "818-669-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 STAMFORD ST",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339522818",
            "telephone_number": "818-669-3091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ GOMEZ",
        "first_name": "JOSE",
        "middle_name": "ERNESTO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "FL",
            "license": "583480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.