De Jesus-Gomez, Gustavo Alberto

De Jesus-Gomez, Gustavo Alberto is an individual health care provider with primary practice located at 5325 Us Hwy 98 S , Lakeland FL 33812-3381. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. De Jesus-Gomez, Gustavo Alberto can be contacted via phone (863) 937-3139.

Contact Information

Primary practice address
5325 Us Hwy 98 S Lakeland FL 33812-3381
Phone: (863) 937-3139
Fax: (863) 937-3147
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 25992 Puerto Rico
Allopathic & Osteopathic Physicians / Surgery 208600000X ME112008 Florida
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X ME112008 Florida

Profile Details

NPI number 1033314190
LBN Legal business name De Jesus-Gomez, Gustavo Alberto
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2007
Last updated Mar 25th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033314190 NPPES
Florida Other 14JQ2 BCBS OF FLORIDA

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