Provider Demographics
NPI:1225302474
Name:GODOY MEDICAL CENTER,INC.
Entity Type:Organization
Organization Name:GODOY MEDICAL CENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GODOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-221-9619
Mailing Address - Street 1:8210A W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2028
Mailing Address - Country:US
Mailing Address - Phone:305-221-9619
Mailing Address - Fax:305-221-4991
Practice Address - Street 1:8210A W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2028
Practice Address - Country:US
Practice Address - Phone:305-221-9619
Practice Address - Fax:305-221-4991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAHCA HCC9392208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty