Provider Demographics
NPI:1255371456
Name:GOFF, LEN H (MD)
Entity type:Individual
Prefix:
First Name:LEN
Middle Name:H
Last Name:GOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:505 APPLEYARD DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-2854
Mailing Address - Country:US
Mailing Address - Phone:850-576-8988
Mailing Address - Fax:850-576-1307
Practice Address - Street 1:505 APPLEYARD DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-2854
Practice Address - Country:US
Practice Address - Phone:850-576-8988
Practice Address - Fax:850-576-1307
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046723207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD29581Medicare UPIN
FL02526UMedicare PIN