| Goji Group LLC | |
|
14394 Commerce Way Miami Lakes FL 33016-1501 | |
| (786) 755-7428 | |
| (786) 755-7426 |
| Full Name | Goji Group LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 14394 Commerce Way, Miami Lakes, Florida |
| Authorized Official Name and Position | Daniel Antonio Otayek (CFO) |
| Authorized Official Contact | 7864409002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Goji Group LLC 14394 Commerce Way Miami Lakes FL 33016-1501 Ph: (786) 755-7428 | Goji Group LLC 14394 Commerce Way Miami Lakes FL 33016-1501 Ph: (786) 755-7428 |
| NPI Number | 1083214142 |
|---|---|
| Provider Enumeration Date | 10/28/2020 |
| Last Update Date | 10/28/2020 |
| Certification Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083214142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 207R00000X | Internal Medicine | () | Secondary |
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