Gomez Hernandez, Luis Manuel

Gomez Hernandez, Luis Manuel is an sole proprietor health care provider with primary practice located at 14400 Nw 77Th Ct Ste 100 , Miami Lakes FL 33016-1590. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Gomez Hernandez, Luis Manuel can be contacted via phone (786) 916-6073.

Contact Information

Primary practice address
14400 Nw 77Th Ct Ste 100 Miami Lakes FL 33016-1590
Phone: (786) 916-6073
Fax: (786) 657-3092
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 11005915 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN11005915 Florida

Profile Details

NPI number 1063043164
LBN Legal business name Gomez Hernandez, Luis Manuel
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 28th, 2020
Last updated Feb 28th, 2022 - about 2 years 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 1063043164 NPPES
Florida MEDICAID 107294700

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