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General NPI Number Information
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NPI Number | 1275399289
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Entity Type | Organization
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Legal Business Name | GO MEDICAL CORP
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Dates
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Enumeration Date | 02/27/2024
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 601 HOWARD ST E
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City | LIVE OAK
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State | FL
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Zip | 32064-3401
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Country | US
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Telephone | 786-873-7045
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Fax |
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Provider Business Mailing Address
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Address Line | 601 HOWARD ST E
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City | LIVE OAK
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State | FL
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Zip | 32064-3401
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Country | US
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Telephone | 786-873-7045
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GIRALDO OLIVERA
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Credential | APRN
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Telephone | 386-320-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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