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General NPI Number Information
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NPI Number | 1093784282
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Entity Type | Individual
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Provider Name | ELIZABETH M. MCGOOGAN ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1701 SE HILLMOOR DR SUITE 19
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7552
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Country | US
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Telephone | 772-335-8455
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Fax | 772-335-4959
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Provider Business Mailing Address
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Address Line | 4450 S TIFFANY DR
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-3241
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Country | US
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Telephone | 561-844-9443
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Fax | 561-844-1013
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP2246612
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License Number State | FL
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