Individual
MR. JEREMY GOODRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4343 SEMINOLE ST, STARKE, FL 32091-9748
(352) 603-4977
Mailing address
PO BOX 1114, STARKE, FL 32091-1114
(352) 603-4977
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN 9217803
FL
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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