Eneida Gomez, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME83444 Issued in FL

Practice address

1750 Tree Blvd
Ste 5
St Augustine, FL 32084-5715

Phone

(904) 342-0672

Fax

(904) 342-0673

NPI assigned

Oct 18, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Panacea Alliance Corp.

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1326298803

  Psychiatry

  Medicare reassignment NPD Authorized official
• Avanti Wellness Center Flllp

  • Community/Behavioral Health Agency
  • St Augustine, FL
  • NPI 1215179056
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1366431835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3123",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320853123",
            "telephone_number": "904-824-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 TREE BLVD",
            "address_2": "STE 5",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320845715",
            "telephone_number": "904-342-0672",
            "fax_number": "904-342-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "ENEIDA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME83444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Goldstein
• Goldwasser Urogynecology PLLC
• Steve Eric Goldwasser, MD
• Kelly Goll, LMHC
• Myragrace Japitana Golmayo, ARNP
• Deanna Gonzalez Headen
• Erika Gonzalez Vazquez
• Clarissa Elizabeth Gonzalez
• Leopoldo B Gonzalez, MD
• Phillip Gonzalez

• Psychiatry Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.