NPIMap

Organization Active NPI

Gomez Clinic Corp

  • Behavior Analyst
  • Miami, FL
National Provider Identifier
1477264695
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
GOMEZ CLINIC CORP
Practice address
6583 SW 39TH Ter Ste B
Miami, FL 33155-4821
Phone
(786) 747-4949
Fax
(786) 756-1010
NPI assigned
Dec 8, 2022
Last updated
Mar 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Eric Campillo, PMHNP
Title
Director
Phone
(305) 300-5551

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

6583 SW 39TH Ter Ste B
Miami, FL 33155-4821

Mailing address

6583 SW 39TH Ter Ste B
Miami, FL 33155-4821
Phone (305) 300-5551

Other identifiers 1

IdentifierTypeStateIssuer
116427200MedicaidFL

Other names 1

  • GOMEZ CLINIC CORP Former legal business name

National Provider Directory

National Provider Directory

Locations

6583 SW 39th Ter
Ste B
Miami, FL 33155
Phone (786) 747-4949

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1477264695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6583 SW 39TH TER STE B",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554821",
            "telephone_number": "305-300-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6583 SW 39TH TER STE B",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554821",
            "telephone_number": "786-747-4949",
            "fax_number": "786-756-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOMEZ CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-08",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "CAMPILLO",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "305-300-5551",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116427200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOMEZ CLINIC CORP",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "GOMEZ CLINIC CORP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Mar 24, 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.