# DOCTORS GOODWILL FOUNDATION, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124679436
- **Authorized official:** KANTILAL BHALANI MD (DIRECTOR)
- **Authorized official phone:** (321) 298-5531

## Contact information

- **Practice address:** 123 S PARK AVE, TITUSVILLE, FL 32796-3377
- **Practice address phone:** (321) 567-4869
- **Practice address fax:** (321) 567-4874
- **Mailing address:** 3 INDIAN RIVER AVE APT 1001, TITUSVILLE, FL 32796-5821
- **Mailing address phone:** (321) 298-5531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/27/2019
- **Last updated:** 09/27/2019