Individual
TIMOTHY JUSTIN GOEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6716 NW 11TH PL STE 200, GAINESVILLE, FL 32605
(352) 331-9729
(352) 331-0136
Mailing address
6716 NW 11TH PL STE 200, GAINESVILLE, FL 32605-4201
(352) 331-9729
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME135579
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024778300
—
FL
01
—
JK893
MEDICARE
—
01
—
JK894
MEDICARE
—
01
—
NFZVZ
BCBS
FL
Enumeration date
05/24/2012
Last updated
03/08/2022
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