Provider Demographics
NPI:1275728693
Name:ANNE GOFF AND ASSOCIATES PA
Entity Type:Organization
Organization Name:ANNE GOFF AND ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOFF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-581-0017
Mailing Address - Street 1:2609 NE 35TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1521
Mailing Address - Country:US
Mailing Address - Phone:954-581-0017
Mailing Address - Fax:
Practice Address - Street 1:2787 E OAKLAND PARK BLVD
Practice Address - Street 2:201
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1647
Practice Address - Country:US
Practice Address - Phone:954-581-0017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24432Medicare PIN