DR. WANDA Y GOMEZ LOPEZ (NPI# 1215030630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215030630 |
| Entity Type | Individual |
| Full Name | DR. WANDA Y GOMEZ LOPEZ |
| Other Name | DR. WANDA Y GOMEZ LOPEZ |
| Credential | M.D. |
| Practice Address |
910 W Vine St Kissimmee FL 34741-4165 |
| Mailing Address |
121 S Orange Ave Ste 940 Orlando FL 32801-3234 |
| Practice Telephone | 4075179582 |
| Practice Fax Number | 4079786644 |
| Mailing Telephone | 4076589687 |
| Mailing Fax Number | 4072864515 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2018-04-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | ACN1011 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | DEA CERTIFICATE | FG6400066 | 01 |
| Street Address |
910 W VINE ST |
| City | KISSIMMEE |
| State | FL |
| Zip Code | 34741-4165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770569733 | Jose Otero-bermudez | General Practice | 910 W Vine St, Kissimmee, FL 34741-4165 | 2005-12-21 |
| 1205347705 | Abel Trimino Espinosa | Nurse Practitioner | 910 W Vine St, Kissimmee, FL 34741-4165 | 2017-10-24 |
| 1992192629 | Alba Susana Severino | Nurse Practitioner | 910 W Vine St, Kissimmee, FL 34741-4165 | 2015-04-21 |
| 1740428424 | Kriselle Torres | General Practice | 910 W Vine St, Kissimmee, FL 34741-4165 | 2009-02-03 |
| 1548480825 | Alexander Rodriguez | General Practice | 910 W Vine St, Kissimmee, FL 34741-4165 | 2007-04-27 |
| 1407884174 | Nancy Nieves-cruz | Internal Medicine | 910 W Vine St, Suite 102, Kissimmee, FL 34741-4165 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083239834 | Kathia I Torres Cintron | Occupational Therapy Assistant | 201 Park Place Blvd Kissimmee Fl 347, Kissimmee, FL 34741 | 2020-06-08 |
| 1992340046 | Zynia Spencer | Marriage & Family Therapist | 345 W. Oak St., Kissimmee, FL 34741 | 2019-11-13 |
| 1225597784 | Leila Rosado | Counselor | All Family, 120 Broadway Suite 204, Kissimmee, FL 34741 | 2019-03-14 |
| 1235610312 | Yashirah Castillo | Behavior Technician | 230 Country Blvd, Apt 6, Kissimmee, FL 34741 | 2018-08-27 |
| 1376021352 | Julio Cesar Castellanos | Nurse Practitioner | 1050 W Carroll St Apt 149, Kissimmee, FL 34741 | 2018-08-01 |
| 1245724715 | Sonia Teresa Rodriguez | Counselor | 3438 W. Vine Street, Kissimmee, FL 34741 | 2018-06-19 |
| 1700376316 | Jessica Mateo | Social Worker | 111 E Monument Ave Unit 412, Kissimmee, FL 34741 | 2018-05-18 |
| 1306340880 | George Gianakakos | Psychiatry & Neurology | 720 W. Oak St., Suite 360, Kissimmee, FL 34741 | 2018-03-20 |
| 1154825693 | Mary Catherine Slome | Student in an Organized Health Care Education/Training Program | 720 W. Oat Street, Ste. 201, Kissimmee, FL 34741 | 2018-03-20 |
| 1457855991 | Sherwin Zachariah Thomas | Student in an Organized Health Care Education/Training Program | 720 W. Oak St., Ste 201, Kissimmee, FL 34741 | 2018-03-20 |
| Find all providers in zip 34741 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326658899 | Fabian Alexander Turushina Montano | General Practice | 124 Pine Island Cir, Kissimmee, FL 34743-8170 | 2020-08-08 |
| 1346876497 | Heloisa Souza Leon | General Practice | 2951 Tindall Acres Rd, Kissimmee, FL 34744-9235 | 2020-03-20 |
| 1952871964 | Digital Noema | General Practice | 501 E Oak St Ste F, Kissimmee, FL 34744-4554 | 2018-12-03 |
| 1871959650 | Shagufta Abbas | General Practice | 4503 Saint Georges Ct, Kissimmee, FL 34746-5860 | 2016-01-08 |
| 1952770752 | Kingdom Come Enterprises Inc | General Practice | 2509 Oak Run Blvd, Kissimmee, FL 34744-3019 | 2015-09-22 |
| 1861886608 | Michael J Thrasher | General Practice | 1001 W Cherry St Ste A, Kissimmee, FL 34741-4111 | 2015-03-18 |
| 1578990438 | Rafael Martinez | General Practice | 2559 E Irlo Bronson Memorial Hwy, Kissimmee, FL 34744 | 2013-10-08 |
| 1992022560 | The Biltmore Group LLC | General Practice | 445 W Oak St, Kissimmee, FL 34741-6627 | 2010-04-22 |
| 1811139520 | Leomaris A Trujillo Santiago | General Practice | 222 Broadway Unit 202, Kissimmee, FL 34741-5760 | 2009-03-26 |
| 1528212651 | Kissimmee Primary Care/ Anti-aging Wellness and Weight Loss Center Pa | General Practice | 1520 N. John Young Parkway, Kissimmee, FL 34741-3219 | 2008-11-17 |
| Find all providers in KISSIMMEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.