Provider Demographics
NPI:1417834359
Name:HERRERA GOMEZ, DAVID ALEXANDER
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ALEXANDER
Last Name:HERRERA GOMEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 SE 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33035-1981
Mailing Address - Country:US
Mailing Address - Phone:863-812-7309
Mailing Address - Fax:
Practice Address - Street 1:2720 SE 23RD AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33035-1981
Practice Address - Country:US
Practice Address - Phone:863-812-7309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant