Provider Demographics
NPI:1780067520
Name:GOODSELL, ALBERT (APRN)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:GOODSELL
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4980 TAMIAMI TRL N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2849
Mailing Address - Country:US
Mailing Address - Phone:239-649-2300
Mailing Address - Fax:239-649-2354
Practice Address - Street 1:4980 TAMIAMI TRL N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2849
Practice Address - Country:US
Practice Address - Phone:239-649-2300
Practice Address - Fax:239-649-2354
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2815132363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily