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Individual
VANESSA L GOLDBACH
Active
Individual
VANESSA L GOLDBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
PA9103811
FL
363A00000X
Physician Assistant
Primary
PA9103811
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292973200
—
FL
01
—
Y0K5Q
BLUE CROSS
FL
Enumeration date
12/26/2007
Last updated
08/19/2020
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