Healthcare Provider Details

I. General information

NPI: 1467875658
Provider Name (Legal Business Name): RHONDA M GOODALL LMT FS RCA LE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2014
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 LEE RD
WINTER PARK FL
32789-1755
US

IV. Provider business mailing address

2445 LEE RD
WINTER PARK FL
32789-1755
US

V. Phone/Fax

Practice location:
  • Phone: 407-547-5576
  • Fax:
Mailing address:
  • Phone: 407-547-5576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA59371
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: