Provider Demographics
NPI:1922109016
Name:GOYOS, JOSE MANUEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:MANUEL
Last Name:GOYOS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7947
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33468-7947
Mailing Address - Country:US
Mailing Address - Phone:561-844-4452
Mailing Address - Fax:561-844-4471
Practice Address - Street 1:1402 ROYAL PALM BEACH BLVD
Practice Address - Street 2:SUITE 400A
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1691
Practice Address - Country:US
Practice Address - Phone:561-844-4452
Practice Address - Fax:561-844-4471
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00019021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ2348Medicare ID - Type Unspecified