Healthcare Provider Details

I. General information

NPI: 1508839135
Provider Name (Legal Business Name): NAVEEN GOEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6766 W SUNRISE BLVD STE 100
PLANTATION FL
33313-6072
US

IV. Provider business mailing address

PO BOX 277180
ATLANTA GA
30384-7180
US

V. Phone/Fax

Practice location:
  • Phone: 954-583-8472
  • Fax: 954-583-8476
Mailing address:
  • Phone: 610-644-8900
  • Fax: 610-771-4225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME97536
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: