Individual
DONALD JOSEPH GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
143 EXECUTIVE CIR, DAYTONA BEACH, FL 32114-1180
(727) 824-0780
(813) 514-8891
Mailing address
6101 BLUE LAGOON DR STE 400, MIAMI, FL 33126-2051
(727) 824-0780
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35062914G
OH
207Q00000X
Family Medicine Physician
Primary
ME111388
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004381401
—
FL
Enumeration date
09/25/2006
Last updated
10/13/2020
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