Organization
OSTEOPATHIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTOPHER SEAN GODDARD D.O. (MGRM)
(305) 367-1176
Entity
Organization
Contact information
Practice address
3915 BISCAYNE BLVD STE 406, MIAMI, FL 33137-3737
(305) 367-1176
(877) 391-0039
Mailing address
3915 BISCAYNE BLVD STE 406, MIAMI, FL 33137-3737
(305) 367-1176
(877) 391-0039
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
OS10979
FL
261Q00000X
Clinic/Center
1037
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0054L
BCBS
FL
Enumeration date
12/18/2013
Last updated
02/16/2022
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