Active NPI
Mario Gomez MD PA
- Obstetrics & Gynecology Physician
- Homestead, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- ME102113
- Legal business name
- MARIO GOMEZ MD PA
- Practice address
- 925 NE 30TH Ter
Suite 300
Homestead, FL 33033-7613 - Phone
- (786) 256-4174
- NPI assigned
- Apr 5, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mario Gomez, MD
- Title
- President
- Phone
- (786) 256-4174
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | ME102113 | FL | Primary |
Addresses
Primary practice location
925 NE 30TH Ter
Suite 300
Homestead, FL 33033-7613
Mailing address
8775 SW 164 St
Palmetto Bay, FL 33157-3562
Phone (786) 256-4174
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001046400 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2027399 | Mario Gomez MD PA | Certificate of waiver | Jul 24, 2027 |
National Provider Directory
National Provider DirectoryLocations
925 NE 30th Ter
Ste 304
Homestead, FL 33033
Phone (786) 377-2500
Networks
- HealthSun Health Plans Network
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Homestead, FL
- NPI 1033386131
-
- Obstetrics & Gynecology Nurse Practitioner
- Homestead, FL
- NPI 1881402394
-
- Family Nurse Practitioner
- Homestead, FL
- NPI 1538744461
-
- Midwife
- Miami, FL
- NPI 1710656863
-
- Family Nurse Practitioner
- Montgomery, AL
- NPI 1386190270
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301961600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1301961600000",
"number": "1538458153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8775 SW 164 ST",
"city": "PALMETTO BAY",
"state": "FL",
"postal_code": "331573562",
"telephone_number": "786-256-4174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 NE 30TH TER",
"address_2": "SUITE 300",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330337613",
"telephone_number": "786-256-4174"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARIO GOMEZ MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2011-04-05",
"last_updated": "2011-04-05",
"status": "A",
"authorized_official_last_name": "GOMEZ",
"authorized_official_first_name": "MARIO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "786-256-4174",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": "FL",
"license": "ME102113",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001046400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Homestead, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.