Juan Gomez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW16785 Issued in FL

Practice address

4217 SW 64TH Ave Ste 1
Davie, FL 33314-3446

Phone

(954) 432-1812

Fax

(954) 432-7740

NPI assigned

Nov 1, 2019

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Practice roles

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.

• Integrated-1 Corp

  dba Dornoch Place Del Prado

  • Assisted Living Facility
  • Cape Coral, FL
  • NPI 1841543550
  NPD (past)

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1730723727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 SW 101ST AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333247441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 SW 64TH AVE STE 1",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143446",
            "telephone_number": "954-432-1812",
            "fax_number": "954-432-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JUAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaneli Gomero, RBT
• Paola Gomez Diaz, PHD, LMHC
• Emirzay De Jesus Gomez Garrido
• Jose Francisco Gomez Sosa, DDS
• Jorge Armando Gomez
• Krystel Gomez
• Lyan Gondin Hernandez, MD
• Khallilah Gonsalves, COTA
• Rene Gonzales Camacho, O.D.
• Daniel Alejandro Gonzales-Portillo

• Clinical Social Worker in Davie, FL
• Providers in Davie, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.