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JEFFREY LEE GOLDHAGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
655 W 8TH ST, UFJP PEDIATRIC DEPARTMENT, JACKSONVILLE, FL 32209-6511
(904) 244-7023
(904) 244-3028
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME67608
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3735087-00
FL
Enumeration date
01/08/2007
Last updated
11/25/2009
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