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General NPI Number Information
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NPI Number | 1972067155
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Entity Type | Organization
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Legal Business Name | REBECCA A. GOFF APRN, IBCLC, LLC
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 1680 S FISKE BLVD
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City | ROCKLEDGE
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State | FL
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Zip | 32955-2535
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Country | US
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Telephone | 321-866-8484
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Fax | 321-333-5696
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Provider Business Mailing Address
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Address Line | 255 MADRID CT
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City | MERRITT IS
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State | FL
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Zip | 32953-3046
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Country | US
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Telephone | 561-859-9334
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MRS. REBECCA A A GOFF
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Credential | APRN, IBCLC
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Telephone | 321-866-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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