Healthcare Provider Details

I. General information

NPI: 1386999688
Provider Name (Legal Business Name): JEFFREY ROBERT GODIN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2012
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 S MILITARY TRL STE D7
WEST PALM BEACH FL
33415-3977
US

IV. Provider business mailing address

925 S MILITARY TRL STE D7
WEST PALM BEACH FL
33415-3977
US

V. Phone/Fax

Practice location:
  • Phone: 561-247-1577
  • Fax:
Mailing address:
  • Phone: 561-247-1577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPU10513
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS49125
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPS49125
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: