Xiomara M Gomez Heredia

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

12088 Issued in PR

Practice address

1409 Ave Ponce de Leon
San Juan, PR 00907-4023

Phone

(787) 960-6818

Fax

(787) 725-4487

NPI assigned

May 23, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679783336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 AVE PONCE DE LEON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009074023",
            "telephone_number": "787-960-6818",
            "fax_number": "787-725-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 AVE PONCE DE LEON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009074023",
            "telephone_number": "787-960-6818",
            "fax_number": "787-725-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ HEREDIA",
        "first_name": "XIOMARA",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "12088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "12088",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edgar J. Gomez del Valle, MSW
• Kevin Gomez Diaz
• Naomie Vanessa Gomez Droz
• Cristobal Gomez Duarte, MD
• Francisco Gomez Goytia, M.D.
• Yariel Josue Gomez Hernandez
• Monica Gomez Martinez, PHARMD
• Jessica Gomez Perales, PSY.D
• Isabel Cristina Gomez Rivera
• Karina Naomi Gomez Ruiz, MS

• General Practice Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.