Provider Demographics
NPI:1700528056
Name:GODOY, JENCY NAHOMY (APRN)
Entity Type:Individual
Prefix:MS
First Name:JENCY
Middle Name:NAHOMY
Last Name:GODOY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 SE 14TH ST
Mailing Address - Street 2:
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004-4695
Mailing Address - Country:US
Mailing Address - Phone:786-295-9090
Mailing Address - Fax:
Practice Address - Street 1:601 E SAMPLE RD STE 107
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-4443
Practice Address - Country:US
Practice Address - Phone:954-210-7016
Practice Address - Fax:954-785-0755
Is Sole Proprietor?:No
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018207208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics