Mariaisys Gomez, APRN
Nurse Practitioner, Pediatrics in Jacksonville, FL. Individual provider (NPI-1).
NPI number1962044016
StatusActive
Last updated in NPPESMar 31, 2023
Details
- NPI
- 1962044016
- Entity type
- Individual (NPI-1)
- Name
- Mariaisys Gomez
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 10, 2019
- Certification date
- Mar 31, 2023
- Last updated
- Mar 31, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | APRN11004148 | FL | Yes |
Practice location
15255 Max Leggett Pkwy Ste 4000Jacksonville, FL 32218-7277
Phone 904-383-1540 · Fax 904-383-1413
Mailing address
15255 Max Leggett Pkwy Ste 4000Jacksonville, FL 32218-7277
Phone 904-383-1540 · Fax 904-383-1413
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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