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NPI Code Detail

MEDICARE: MICHAEL MCGOOHAN DO

MEDICARE: MICHAEL MCGOOHAN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianOS0006325FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
180815OTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386623676
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL MCGOOHAN DO
Provider Business Mailing Address
First Line : PO BOX 918994
Second Line :
City : ORLANDO
State : FL
Zip : 32891-8994
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 701 W COCOA BEACH CSWY
Second Line :
City : COCOA BEACH
State : FL
Zip : 32931-3585
Country : US
Telephone Number : 321-799-7111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2006
Last Update Date : 07/10/2007

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