Individual
DR. ROSS JOHN GOODFELLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
699 W COCOA BEACH CSWY, SUITE 503, COCOA BEACH, FL 32931-3577
(321) 434-6650
(321) 868-8396
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-6650
(321) 951-7408
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
OS10988
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002674000
—
FL
01
—
DO109Y
MEDICARE
FL
Enumeration date
03/24/2006
Last updated
12/05/2024
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