Healthcare Provider Details

I. General information

NPI: 1538878202
Provider Name (Legal Business Name): ARIEL J GOITIA MD CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 NW 82ND AVE STE 408
DORAL FL
33166-7602
US

IV. Provider business mailing address

3625 NW 82ND AVE STE 408
DORAL FL
33166-7602
US

V. Phone/Fax

Practice location:
  • Phone: 305-939-6877
  • Fax:
Mailing address:
  • Phone: 786-425-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ARIEL JOAQUIN GOITIA
Title or Position: DOCTOR / PSYCHIATRIST
Credential: MD
Phone: 786-425-7777