| NPI | 1972067155 |
|---|---|
| Doing Business As | SPACE COAST LACTATION |
| Entity Type | Organization |
| Authorized Contact | REBECCA A A GOFF Provider 321-866-8484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner Women's Health |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2024-11-11 |