Manuel Joaquin Gomez, MD
Individual provider
Active NPI
Pediatrics Physician · Tavernier, FL
NPI 1245274232 · NPPES record last updated Jun 13, 2025
Key facts
- NPI
- 1245274232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- ME92538 (FL)
- Practice address
- 91550 Overseas Hwy Ste 209
Tavernier, FL 33070-2513
- Phone
- (305) 853-0558
- Fax
- (305) 853-0744
- NPI assigned
- Jun 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
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.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20171208001309 |
FL |
Practitioner - Pediatric Medicine |
6204825151 |
|
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|
| ME92538 | FL | MD | Pediatrics Physician |
Practice roles
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Pediatrics Physician |
208000000X |
ME92538 |
FL |
Yes |
Addresses
Primary practice location
91550 Overseas Hwy Ste 209
Tavernier, FL 33070-2513
Mailing address
91550 Overseas Hwy Ste 209
Tavernier, FL 33070-2513
Phone (305) 853-0558
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| ME92538 | Other | FL | MEDICAL DOCTOR |
| 021675800 | Medicaid | FL | |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|
| CONNECT URL |
flkeyspeds@gmail.com |
|
|