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General NPI Number Information
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NPI Number | 1649340258
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Entity Type | Organization
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Legal Business Name | AJAY K GOYAL MD PA
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 2011 SOUTH 25TH STREET SUITE 106
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City | FORT. PIERCE
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State | FL
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Zip | 34947-4795
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Country | US
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Telephone | 772-468-7020
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Fax | 772-468-7698
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Provider Business Mailing Address
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Address Line | 2011 SOUTH 25TH STREET SUITE 106
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City | FORT. PIERCE
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State | FL
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Zip | 34947-4795
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Country | US
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Telephone | 772-468-7020
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Fax | 772-468-7698
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Authorized Official
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Title or Position | PRESIDENT
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Name | AJAY K GOYAL
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Credential | MD
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Telephone | 772-468-7020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME74489
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License Number State | FL
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