DIEGO FERNANDO GOMEZ LCAS-A NPI 1275914111

NPI Information

NPI: 1275914111
Provider Name: DIEGO FERNANDO GOMEZ, LCAS-A
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
15901 BASS RD STE 108
FORT MYERS, FL
ZIP 33908
Phone: (239) 343-6050
Get Directions

Diego Fernando Gomez, LCAS-A is a mental health counselor in Fort Myers, FL. Diego Fernando Gomez, LCAS-A NPI is 1275914111. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

15901 BASS RD STE 108
FORT MYERS, FL
ZIP 33908
Phone: (239) 343-6050
Fax: (239) 343-6051

The enumeration date for this NPI number is 6/16/2015 and was last updated on 9/3/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	MH14194	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100799300	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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