| Keisha Goodison DO, PA | |
|
100 E Sample Rd Suite 300 Pompano Beach FL 33064 | |
| (954) 366-3425 | |
| (954) 366-3510 |
| Full Name | Keisha Goodison DO, PA |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 100 E Sample Rd, Pompano Beach, Florida |
| Authorized Official Name and Position | Keisha Adama Goodison (PRESIDENT) |
| Authorized Official Contact | 9543663425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keisha Goodison DO, PA 100 E Sample Rd Suite 300 Pompano Beach FL 33064-3554 Ph: (954) 366-3425 | Keisha Goodison DO, PA 100 E Sample Rd Suite 300 Pompano Beach FL 33064 Ph: (954) 366-3425 |
| NPI Number | 1710114558 |
|---|---|
| Provider Enumeration Date | 06/19/2009 |
| Last Update Date | 09/04/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710114558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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