Active NPI
Jorge Luis Gomez-Miranda, LMFT
- Marriage & Family Therapist
- Ft Lauderdale, FL
National Provider Identifier
1306156914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT 2202
- Practice address
- 1001 W Commercial Blvd
Ft Lauderdale, FL 33309-3107 - Phone
- (954) 938-0919
- NPI assigned
- Oct 15, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MT 2202 | FL | Primary |
Addresses
Primary practice location
1001 W Commercial Blvd
Ft Lauderdale, FL 33309-3107
Mailing address
1001 W Commercial Blvd
Ft Lauderdale, FL 33309-3107
Phone (954) 938-0919
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 |
|---|---|---|---|
| MT 2202 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1306156914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 W COMMERCIAL BLVD",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333093107",
"telephone_number": "954-938-0919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 W COMMERCIAL BLVD",
"city": "FT LAUDERDALE",
"state": "FL",
"postal_code": "333093107",
"telephone_number": "954-938-0919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ-MIRANDA",
"first_name": "JORGE",
"middle_name": "LUIS",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-15",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT 2202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ft Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.