MEDICARE: RHONDA M GOODALL LMT FS RCA LE

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
1	225700000X	Massage Therapist	MA59371	FL

General Provider Information

NPI Number	:	1467875658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA M GOODALL LMT FS RCA LE

Provider Business Mailing Address
First Line	:	2445 LEE RD
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-1755
Country	:	US
Telephone Number	:	407-547-5576
Fax Number	:

Provider Business Practice Location Address
First Line	:	2445 LEE RD
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-1755
Country	:	US
Telephone Number	:	407-547-5576
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2014
Last Update Date	:	06/01/2026

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