Healthcare Provider Details

I. General information

NPI: 1255396016
Provider Name (Legal Business Name): BACH & GODOFSKY M D P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 POINTE WEST BLVD
BRADENTON FL
34209-5531
US

IV. Provider business mailing address

6010 POINTE WEST BLVD
BRADENTON FL
34209-5531
US

V. Phone/Fax

Practice location:
  • Phone: 941-746-2711
  • Fax: 941-746-3433
Mailing address:
  • Phone: 941-746-2711
  • Fax: 941-746-3433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIOT W. GODOFSKY
Title or Position: OWNER
Credential: M.D.
Phone: 941-746-2711