Provider Demographics
NPI:1871778415
Name:GOMEZ, KEREN HAPUC (DC)
Entity type:Individual
Prefix:DR
First Name:KEREN
Middle Name:HAPUC
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6447 MIAMI LAKES DR
Mailing Address - Street 2:SUITE.206
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2741
Mailing Address - Country:US
Mailing Address - Phone:305-512-4079
Mailing Address - Fax:786-220-9122
Practice Address - Street 1:6447 MIAMI LAKES DR
Practice Address - Street 2:SUITE.206
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2741
Practice Address - Country:US
Practice Address - Phone:305-512-4079
Practice Address - Fax:786-220-9122
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9468111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor