Provider Demographics
NPI:1346288933
Name:GOCO, PAULINO EDWARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULINO
Middle Name:EDWARDO
Last Name:GOCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 GATEWAY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2589
Mailing Address - Country:US
Mailing Address - Phone:615-848-9265
Mailing Address - Fax:615-895-2155
Practice Address - Street 1:1370 GATEWAY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2589
Practice Address - Country:US
Practice Address - Phone:615-848-9265
Practice Address - Fax:615-895-2155
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD36032174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2120899Medicaid
TNH63644Medicare UPIN
TN2120899Medicaid