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NPI Code Detail

MEDICARE: RALPH GOUSSE M. D.

MEDICARE: RALPH GOUSSE M. D.
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
1207RH0000XHematology (Internal Medicine) PhysicianME0061059FL
2207RX0202XMedical Oncology PhysicianME0061059FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457316341
Entity Type Code : Individual
Provider Name (Legal Business Name) : RALPH GOUSSE M. D.
Provider Business Mailing Address
First Line : PO BOX 102222
Second Line : ATTN: CREDENTIAL DEPARTMENT
City : ATLANTA
State : GA
Zip : 30368-2222
Country : US
Telephone Number : 239-274-8200
Fax Number : 239-278-3350
Provider Business Practice Location Address
First Line : 106 BOSTON AVE STE 105
Second Line :
City : ALTAMONTE SPRINGS
State : FL
Zip : 32701-4711
Country : US
Telephone Number : 407-553-7710
Fax Number : 866-445-1446
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 08/06/2022

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