Provider Demographics
NPI:1871579714
Name:GOMEZ, VICTOR HUGO (DC)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:HUGO
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13911 N DALE MABRY HWY STE 107
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2414
Mailing Address - Country:US
Mailing Address - Phone:813-915-5347
Mailing Address - Fax:813-252-1380
Practice Address - Street 1:13911 N DALE MABRY HWY STE 107
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2414
Practice Address - Country:US
Practice Address - Phone:813-915-5347
Practice Address - Fax:813-252-1380
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006598111N00000X
FLCH8856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U82650Medicare UPIN
U6579ZMedicare ID - Type Unspecified