GUILLERMO GOMEZ NP NPI 1972508752

NPI Information

NPI: 1972508752
Provider Name: GUILLERMO GOMEZ, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
4146 JONESBORO RD
FOREST PARK, GA
ZIP 30297
Phone: (404) 361-2469
Get Directions

Guillermo Gomez, NP is a family nurse practitioner in Forest Park, GA. Guillermo Gomez, NP NPI is 1972508752. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4146 JONESBORO RD
FOREST PARK, GA
ZIP 30297-038
Phone: (404) 361-2469

The enumeration date for this NPI number is 6/17/2005 and was last updated on 6/26/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	RN126015 NP	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	810457223B	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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