Healthcare Provider Details

I. General information

NPI: 1780827519
Provider Name (Legal Business Name): REBECCA A GOFF APRN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1680 S FISKE BLVD
ROCKLEDGE FL
32955-2535
US

IV. Provider business mailing address

255 MADRID CT
MERRITT ISLAND FL
32953-3046
US

V. Phone/Fax

Practice location:
  • Phone: 321-866-8484
  • Fax: 321-333-5696
Mailing address:
  • Phone: 561-859-9334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number3325872
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number3325872
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: