Individual
DR. SANDRA LOEB GOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2280 S RIVER RD, MELBOURNE BEACH, FL 32951-2932
(321) 258-8245
Mailing address
2280 S RIVER RD, MELBOURNE BEACH, FL 32951-2932
(321) 258-8245
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
E-4180
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01043833A
LICENSE
IN
05
—
200124250
—
IN
Enumeration date
08/30/2006
Last updated
02/27/2018
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