Individual provider Active NPI

Miguel Angel Gomez Rodriguez, DO

  • Student in an Organized Health Care Education/Training Program
  • Pembroke Pines, FL
National Provider Identifier
1740930288
Registry record updated Mar 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
703 N Flamingo Rd
Pembroke Pines, FL 33028-1014
Phone
(954) 261-0281
NPI assigned
Mar 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

703 N Flamingo Rd
Pembroke Pines, FL 33028-1014

Mailing address

5251 SW 159TH Ave
Miramar, FL 33027-4994
Phone (954) 261-0281

Other names 1

  • Miguel Angel Gomez Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220607000603 FL Order and Referring Only - NeurologyPractitioner - Neurology 3375921117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1648339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648339200000",
    "number": "1740930288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5251 SW 159TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274994",
            "telephone_number": "954-261-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N FLAMINGO RD",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281014",
            "telephone_number": "954-261-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ RODRIGUEZ",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-27",
        "last_updated": "2022-03-27",
        "certification_date": "2022-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIGUEL",
            "last_name": "GOMEZ",
            "middle_name": "ANGEL",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.