Organization
KELLER & GOODMAN MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY ALAN GOODMAN MD (OWNER)
(352) 742-7776
Entity
Organization
Contact information
Practice address
1879 NIGHTINGALE LN, SUITE C-2, TAVARES, FL 32778-4363
(352) 742-7776
(352) 742-7750
Mailing address
1879 NIGHTINGALE LN, SUITE C-2, TAVARES, FL 32778-4363
(352) 742-7776
(352) 742-7750
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME66294
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25425
BLUE CROSS
—
05
—
375405700
—
FL
Enumeration date
03/06/2007
Last updated
07/08/2008
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