Individual
KRISTOPHER JOSEPH SEAN GODDARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
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
2081
TN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
OS10979
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0045L
BCBS
FL
Enumeration date
11/02/2009
Last updated
02/16/2022
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