Sofia Raquel Gomez , PED LIC #
Contractor • Phoenix, AZ
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Sofia Gomez has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Sofia Gomez, PED LIC # was a registered Contractor practicing in Phoenix, AZ. Throughout an active medical career spanning 9 years, Sofia Gomez provided care at the practice location at 1320 W FREMONT RD until profile deactivation on 2020-05-08.
Practice Location & Contact Primary Location
1320 W Fremont Rd
Phoenix, AZ 850416725
Specialty Benchmarks & Practice Insights
Comparative analytics for Contractor in Phoenix, AZ
Practicing in Phoenix, AZ (348 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 171W00000X
A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on May 08, 2020
NPI status registered as active in NPPES database
Registered at 1320 W FREMONT RD, PHOENIX, AZ 850416725 (Tel: 4802002328)
Registered at 1320 W FREMONT RD, PHOENIX, AZ 850416725 (Tel: 4802002328)
Recorded as SOFIA GOMEZ, PED LIC #17451
Contractor (License #17451 in AK)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
1320 W Fremont Rd
Phoenix, AZ 850416725
Phone: 4802002328
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