Provider Demographics
NPI:1881023364
Name:GODOY BECKER, GEORGINA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:GEORGINA MARIA
Middle Name:
Last Name:GODOY BECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 MAGUIRE BLVD
Mailing Address - Street 2:APT 2113
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-7212
Mailing Address - Country:US
Mailing Address - Phone:407-538-9989
Mailing Address - Fax:
Practice Address - Street 1:133 BENMORE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4111
Practice Address - Country:US
Practice Address - Phone:407-646-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL117917207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine