Organization
GOODWILLUS MEDICAL CLINIC, LLC
Active
Other names
GOODWILLUS MEDICAL CLINIC LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ADETOLA ADEYANJU-ISHOLA (PRESIDENT/CEO)
(727) 862-3600
Entity
Organization
Contact information
Practice address
7037 STATE ROAD 52, HUDSON, FL 34667-6706
(727) 862-3600
(727) 862-8899
Mailing address
7037 STATE ROAD 52, HUDSON, FL 34667-6706
(727) 862-3600
(727) 862-8899
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME56548
FL
Other
Enumeration date
10/08/2010
Last updated
10/28/2011
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