Organization Active NPI

Joaquin a. Gomez, MD, PA

  • Pediatrics Physician
  • Miami, FL
National Provider Identifier
1780720227
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME 75444 Issued in FL
Legal business name
JOAQUIN A. GOMEZ, MD, PA
Practice address
2760 SW 97TH Ave
#105
Miami, FL 33165-2684
Phone
(305) 228-7120
Fax
(305) 228-6153
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Authorized official

Name
Dr. Joaquin Alberto Gomez, M.D.NPI 1295742815
Title
President
Phone
(305) 228-7120

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)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME 75444 FL Primary

Addresses

Primary practice location

2760 SW 97TH Ave
#105
Miami, FL 33165-2684

Mailing address

2760 SW 97TH Ave
#105
Miami, FL 33165-2684
Phone (305) 228-7120

Other identifiers 1

IdentifierTypeStateIssuer
254051700MedicaidFL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0998454Joaquin a Gomez MD PA2760 SW 97TH Ave Ste 105, Miami, FL 33165Certificate of waiverApr 15, 2028

National Provider Directory

National Provider Directory

Locations

2760 SW 97th Ave
Apt 105
Miami, FL 33165
Phone (305) 228-3714

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1780720227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 SW 97TH AVE",
            "address_2": "#105",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331652684",
            "telephone_number": "305-228-7120",
            "fax_number": "305-228-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 SW 97TH AVE",
            "address_2": "#105",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331652684",
            "telephone_number": "305-228-7120",
            "fax_number": "305-228-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOAQUIN A. GOMEZ, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "JOAQUIN",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-228-7120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 75444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254051700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.