Individual
LISA GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1395 W BAY DR, LARGO, FL 33770-2205
(727) 584-6802
Mailing address
5364 ELISEO ST, SARASOTA, FL 34238-4791
(407) 831-6200
(407) 831-1068
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN9327272
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008881100
—
FL
Enumeration date
10/28/2011
Last updated
08/13/2024
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