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Individual

DR. SHAWN EDWARD GOUGH-FIBKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9824 SW 133RD CT, MIAMI, FL 33186-2203
(305) 382-4378
Mailing address
9824 SW 133RD CT, MIAMI, FL 33186-2203
(305) 382-4378

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME 90529
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2792796
OH
Enumeration date
01/19/2006
Last updated
04/16/2008
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