| NPI | 1629564463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTOPHER GODDARD Ownder 305-367-1176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: FL os10979) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL os10979) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: FL os10979) | |
| 2083S0010X Preventive Medicine, Sports Medicine (Licence: FL os10979) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: FL os10979) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL os10979) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL os10979) | |
| 213EP1101X Podiatrist, Primary Podiatric Medicine | |
| 213ER0200X Podiatrist, Radiology | |
| 213ES0000X Podiatrist, Sports Medicine | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2018-07-05 |