Individual provider Active NPI

Rafael T. Gomez, MD

  • Psychiatry Physician
  • Gainesville, FL
National Provider Identifier
1609972751
Registry record updated Aug 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25088 Issued in FL
Practice address
1200 NE 55TH Boulevard
Nfetc
Gainesville, FL 32641-2759
Phone
(352) 375-8484
Fax
(352) 264-8304
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME25088 FL
Psychiatry Physician 2084P0800X 25088 FL Primary

Addresses

Primary practice location

1200 NE 55TH Boulevard
Nfetc
Gainesville, FL 32641-2759

Mailing address

1200 NE 55TH Boulevard
North Florida Education & Treatment Center
Gainesville, FL 32641-2759
Phone (352) 375-8484

Other identifiers 1

IdentifierTypeStateIssuer
056477000MedicaidFL

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25088FLMDGeneral Practice Dentistry
ME25088FLMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249603200000",
    "number": "1609972751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NE 55TH BOULEVARD",
            "address_2": "NORTH FLORIDA EDUCATION & TREATMENT CENTER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326412759",
            "telephone_number": "352-375-8484",
            "fax_number": "352-264-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NE 55TH BOULEVARD",
            "address_2": "NFETC",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326412759",
            "telephone_number": "352-375-8484",
            "fax_number": "352-264-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "RAFAEL",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2009-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME25088",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "25088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056477000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; 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.