Individual provider Active NPI

Roberto A Gomez-Suarez, M.D.

  • Pediatric Gastroenterology Physician
  • Melbourne, FL
National Provider Identifier
1952503674
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
2010-01413 Issued in NC
Practice address
1717 South Orange Ave.
Suite #100
Melbourne, FL 32901-3224
Phone
(407) 650-7000
Fax
(407) 567-5924
NPI assigned
Jun 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 2010-01413 NC Primary

Addresses

Primary practice location

1717 South Orange Ave.
Suite #100
Melbourne, FL 32901-3224

Mailing address

PO Box 191
Provider Enrollment Department
Rockland, DE 19732-0191
Phone (302) 651-6212

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
I20161206001808 FL Practitioner - GastroenterologyPractitioner - Pediatric Medicine 7517081276 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010-01413NCMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Sep 26, 2016 Accepting new patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Sep 26, 2016 Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

1717 S Orange Ave
Ste 100
Orlando, FL 32806

Interoperability endpoints

  • Direct secure messaging: rgomezsuarez44137@direct.nemours.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1952503674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPARTMENT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SOUTH ORANGE AVE.",
            "address_2": "SUITE #100",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013224",
            "telephone_number": "407-650-7000",
            "fax_number": "407-567-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ-SUAREZ",
        "first_name": "ROBERTO",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NC",
            "license": "2010-01413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.