Healthcare Provider Details

I. General information

NPI: 1992736722
Provider Name (Legal Business Name): KATHLEEN ANNE GOFF A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN ANNE CRALL

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 STURTEVANT ST
ORLANDO FL
32806-2012
US

IV. Provider business mailing address

44 STURTEVANT ST
ORLANDO FL
32806-2012
US

V. Phone/Fax

Practice location:
  • Phone: 407-423-1039
  • Fax: 407-425-2347
Mailing address:
  • Phone: 407-423-1039
  • Fax: 407-425-2347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1727422
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN1727422
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: