Gomez, Manuel O.

Gomez, Manuel O. is an sole proprietor health care provider with primary practice located at 141 E Central Ave Ste 340 , Winter Haven FL 33880. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Gomez, Manuel O. can be contacted via phone (863) 412-8711.

Contact Information

Primary practice address
141 E Central Ave Ste 340 Winter Haven FL 33880
Phone: (863) 412-8711
Fax: (877) 340-0107
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X ABC010814-215 Florida
Behavioral Health & Social Service Providers / Professional 101YP2500X 6158 Florida
Other Service Providers / Case Manager/Care Coordinator 171M00000X 131096 Florida
Other Service Providers / Case Manager/Care Coordinator 171M00000X 689259179 Florida
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 11142 Florida

Profile Details

NPI number 1285876409
LBN Legal business name Gomez, Manuel O.
Credentials MS., LMH,MCAP, CCM,
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 2nd, 2009
Last updated Sep 27th, 2018 - about 6 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 1285876409 NPPES
Florida MEDICAID 689259179

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