Provider Demographics
NPI:1861681181
Name:GOITZ, VICTORIA ELIZABETH (DPM)
Entity Type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:ELIZABETH
Last Name:GOITZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2766 LOGANDALE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-2786
Mailing Address - Country:US
Mailing Address - Phone:407-679-0449
Mailing Address - Fax:
Practice Address - Street 1:15228 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-5134
Practice Address - Country:US
Practice Address - Phone:407-568-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2625213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU97379Medicare UPIN
FL65705ZMedicare PIN